Organization
CROSSWAY, INC.
Active
Organization
CROSSWAY, INC.
Active
Other names
Crossway Pediatric Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHELLEY ANNE DEAN OTD,OTR/L (OWNER, OCCUPATIONAL THERAPIST)
(704) 607-0014
Entity
Organization
Contact information
Practice address
9129 MONROE RD, SUITE 100-015, CHARLOTTE, NC 28270-2429
(704) 847-3911
(704) 847-2033
Mailing address
9129 MONROE RD, SUITE 100-105, CHARLOTTE, NC 28270-2429
(704) 847-3911
(704) 442-8724
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
—
—
225X00000X
Occupational Therapist
Primary
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
017H3
GROUP NUMBER
NC
01
—
183EE
BCBS INDIVIDUAL NUMBER
NC
05
—
7211844
—
NC
05
—
7301435
—
NC
01
—
B0333
MEDCOST INDIVIDUAL NUMBER
NC
Enumeration date
06/15/2006
Last updated
08/05/2016
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