Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0200X | Occupational Therapist - Pediatrics | 8376 | NC |
NPI | 1003165473 |
---|---|
Provider Name | Mrs. Ashleigh Danielle Shinkle |
First Address | Raeford, NC 28376-2728 |
Second Address | Fayetteville, NC 28304-4321 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/08/2012 |
Last Update Date | 04/11/2015 |