Individual
MS. JACQUELINE LLOYDETTE SHIVLEY-CASTLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
501 CALDWELL LN, DUNBAR, WV 25064-2026
(304) 744-4761
Mailing address
404 BLUESTONE RD, BECKLEY, WV 25801-2010
(304) 673-1280
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
C1945
WV
Other
Enumeration date
11/29/2017
Last updated
11/29/2017
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