Provider Demographics
NPI:1033324918
Name:DOSTIE, SHELLEY (OTR L)
Entity Type:Individual
Prefix:MRS
First Name:SHELLEY
Middle Name:
Last Name:DOSTIE
Suffix:
Gender:F
Credentials:OTR L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 WESTFORD DR
Mailing Address - Street 2:
Mailing Address - City:ASHFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06278-1931
Mailing Address - Country:US
Mailing Address - Phone:860-429-2646
Mailing Address - Fax:
Practice Address - Street 1:25 WESTFORD DR
Practice Address - Street 2:
Practice Address - City:ASHFORD
Practice Address - State:CT
Practice Address - Zip Code:06278-1931
Practice Address - Country:US
Practice Address - Phone:860-429-2646
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT002022225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist