Individual
SHANELLE BISPHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
231 AVENUE C # 2L, BAYONNE, NJ 07002-2550
(201) 540-6551
Mailing address
231 AVENUE C # 2L, BAYONNE, NJ 07002-2550
(201) 540-6551
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
011831
NY
Other
Enumeration date
06/02/2026
Last updated
06/02/2026
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