Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225X00000X | Occupational Therapist | 4966 | MA |
N | 225XH1200X | Occupational Therapist - Hand | 4966 | MA |
N | 225XN1300X | Occupational Therapist - Neurorehabilitation | 4966 | MA |
NPI | 1245377381 |
---|---|
Provider Name | Ms. Deborah Ann Shipkin |
First Address | West Tisbury, MA 02575-0130 |
Second Address | West Tisbury, MA 02575-0130 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/01/2007 |
Last Update Date | 08/07/2007 |