Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 1404 | CA |
N | 225XF0002X | Feeding, Eating & Swallowing | 1404 | CA |
N | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 1404 | CA |
NPI | 1124343769 |
---|---|
Provider Name | Mrs. Shelley Ann Wilkinson |
First Address | Seaside, CA 93955-3947 |
Second Address | Monterey, CA 93940-6741 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/04/2010 |
Last Update Date | 06/04/2010 |