Individual
SHAWNALEA SHELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTRL
Contact information
Practice address
2314 S VAL VISTA DR STE 201, GILBERT, AZ 85295-5594
(623) 263-3966
Mailing address
23015 S 182ND ST, GILBERT, AZ 85298-8959
(480) 299-2944
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
0779
AZ
225X00000X
Occupational Therapist
OT00003805
WA
225X00000X
Occupational Therapist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
275138
—
OR
Enumeration date
11/30/2005
Last updated
09/25/2024
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