Provider Demographics
NPI:1063657039
Name:HIX, SHELLEY O (OT)
Entity Type:Individual
Prefix:
First Name:SHELLEY
Middle Name:O
Last Name:HIX
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:192 ANTLER RIDGE CIR
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37214-4744
Mailing Address - Country:US
Mailing Address - Phone:615-400-5138
Mailing Address - Fax:
Practice Address - Street 1:1210 BRIARVILLE RD BLDG D
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:TN
Practice Address - Zip Code:37115-5136
Practice Address - Country:US
Practice Address - Phone:615-612-7602
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-12-04
Last Update Date:2008-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist