Individual
MR. TIMOTHY SEAN SHIRLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
COTA/L
Contact information
Practice address
109 CAPRI DR, ORMOND BEACH, FL 32176-2233
(386) 405-6586
Mailing address
109 CAPRI DR, ORMOND BEACH, FL 32176-2233
(386) 405-6586
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA12716
FL
Other
Enumeration date
08/27/2013
Last updated
11/11/2020
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