Provider Demographics
NPI:1114113875
Name:SHAW, SHERRIE BILLINGS (OTA/L)
Entity Type:Individual
Prefix:
First Name:SHERRIE
Middle Name:BILLINGS
Last Name:SHAW
Suffix:
Gender:F
Credentials:OTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 ROSS ST
Mailing Address - Street 2:
Mailing Address - City:RUTLAND
Mailing Address - State:VT
Mailing Address - Zip Code:05701-3633
Mailing Address - Country:US
Mailing Address - Phone:802-773-6439
Mailing Address - Fax:
Practice Address - Street 1:GENESIS HEALTH CARE
Practice Address - Street 2:9 HAYWOOD AVE.
Practice Address - City:RUTLAND
Practice Address - State:TN
Practice Address - Zip Code:05701
Practice Address - Country:US
Practice Address - Phone:802-747-5100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-17
Last Update Date:2007-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT0730000065224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant