Individual
MRS. SHELLY LYNN SHIPLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
1405 TRUAX BLVD, EAU CLAIRE, WI 54703-1474
(715) 552-1030
Mailing address
1405 TRUAX BLVD, EAU CLAIRE, WI 54703-1474
(715) 552-1030
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
1840-027
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40903900
—
WI
Enumeration date
12/18/2006
Last updated
07/09/2007
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