Provider Demographics
NPI:1083915615
Name:PACHECO, SHAAYNA JESSICA (MS, OTR/L)
Entity Type:Individual
Prefix:MS
First Name:SHAAYNA
Middle Name:JESSICA
Last Name:PACHECO
Suffix:
Gender:F
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9650 HAITIAN DR
Mailing Address - Street 2:
Mailing Address - City:CUTLER BAY
Mailing Address - State:FL
Mailing Address - Zip Code:33189-1608
Mailing Address - Country:US
Mailing Address - Phone:786-239-8646
Mailing Address - Fax:
Practice Address - Street 1:9650 HAITIAN DR
Practice Address - Street 2:
Practice Address - City:CUTLER BAY
Practice Address - State:FL
Practice Address - Zip Code:33189-1608
Practice Address - Country:US
Practice Address - Phone:786-239-8646
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-12
Last Update Date:2010-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT14010225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist