Individual
SHELLEY PEASLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
214 CHURCH DR, MASTIC BEACH, NY 11951-1207
(631) 965-8688
Mailing address
214 CHURCH DR, MASTIC BEACH, NY 11951-1207
(631) 965-8688
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
009041-1
NY
Other
Enumeration date
09/07/2016
Last updated
09/07/2016
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