Individual
KELSEY SHIBEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
355 WILLIAM MILLS DR, STANARDSVILLE, VA 22973-3055
(434) 985-4434
Mailing address
355 WILLIAM MILLS DR, STANARDSVILLE, VA 22973-3055
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
0119007035
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0119007035
OTR LICENSE
VA
Enumeration date
08/16/2018
Last updated
08/16/2018
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