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Organization

SUCCESSFUL CHILD THERAPY LLC

Active
Other names
Melinda Beth Shellenberger
Organization subpart
No

Provider details

NPI number
Authorized official
MELINDA BETH SHELLENBERGER OTR LICENSED (OWNER)
(316) 260-2251
Entity
Organization

Contact information

Practice address
1811 E BEAUMONT ST, PARK CITY, KS 67219-2420
(316) 260-2251
(316) 744-3152
Mailing address
1811 E BEAUMONT ST, PARK CITY, KS 67219-2420
(316) 260-2251
(316) 744-3152

Taxonomy

Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
1701909
KS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
115686
BCBS GROUP
KS
01
PHS
PREFERRED HEALTH SYSTEMS
KS
Enumeration date
12/05/2006
Last updated
05/28/2008
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