Individual
MRS. SHELLEY NICOLE WYATT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
3057 LORNA RD STE 220, BIRMINGHAM, AL 35216-4518
(205) 978-9939
Mailing address
568 REACH DR, BIRMINGHAM, AL 35242-8646
(205) 253-2887
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
2857
AL
Other
Enumeration date
12/05/2011
Last updated
12/05/2011
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