Individual
SHELLEY BANKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
821 GREENWOOD DR, LODI, CA 95240-0433
(209) 327-3309
Mailing address
821 GREENWOOD DR, LODI, CA 95240-0433
(209) 327-3309
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
6053
CA
Other
Enumeration date
02/02/2021
Last updated
02/02/2021
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