Individual
SHELLEY L EARLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
4923 US ROUTE 5, SOJOURNS COMMUNITY HEALTH CLINIC, WESTMINSTER, VT 05158-9651
(802) 722-4023
(802) 722-4137
Mailing address
4923 US ROUTE 5, SOJOURNS COMMUNITY HEALTH CLINIC, WESTMINSTER, VT 05158-9651
(802) 722-4023
(802) 722-4137
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
072-0000562
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
072-0000562
VT STATE LICENSE
VT
Enumeration date
07/22/2007
Last updated
07/22/2007
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