Individual
MS. SHELLEY VICKY ANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
2 DUDLEY ST, SUITE 200, PROVIDENCE, RI 02905-3248
(401) 457-2158
(401) 457-2198
Mailing address
PO BOX 1119, PROVIDENCE, RI 02901-1119
(401) 457-1580
(401) 831-0500
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
10010
MA
225XH1200X
Hand Occupational Therapist
Primary
292
RI
Other
Enumeration date
01/22/2010
Last updated
10/19/2012
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