Provider Demographics
NPI:1225768997
Name:DIMPLE, SHALINI (OTR/L)
Entity Type:Individual
Prefix:
First Name:SHALINI
Middle Name:
Last Name:DIMPLE
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 1:8313 GOVERNOR RIDGLEY LN
Mailing Address - Street 2:
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21043-3451
Mailing Address - Country:US
Mailing Address - Phone:732-986-1486
Mailing Address - Fax:
Practice Address - Street 1:5412 OLD COURT RD
Practice Address - Street 2:
Practice Address - City:RANDALLSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21133-5104
Practice Address - Country:US
Practice Address - Phone:410-922-3200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-14
Last Update Date:2022-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty