Individual
SHELLENE CLEMENTS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
10445 DUPONT OAKS BLVD, FORT WAYNE, IN 46845-8792
(260) 471-4770
Mailing address
PO BOX 207, ASHLEY, IN 46705-0207
(260) 687-1566
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
32003195A
IN
Other
Enumeration date
09/29/2021
Last updated
09/29/2021
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