Individual
SHELBY OLIVER RESENDIZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
3964 GOODMAN RD E STE 105, SOUTHAVEN, MS 38672-8711
(662) 932-4625
Mailing address
7430 MEADOWBROOK DR, HORN LAKE, MS 38637-8329
(901) 647-3456
(662) 349-8757
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
OT-3943
MS
Other
Enumeration date
08/01/2022
Last updated
12/09/2023
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