Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 8823 | NC |
N | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 2432 | FL |
NPI | 1144659293 |
---|---|
Provider Name | Ms. Shelley Scott Campbell |
First Address | Lake Worth, FL 33460-6315 |
Second Address | Lake Worth, FL 33460-6315 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/11/2013 |
Last Update Date | 08/11/2013 |