Provider Demographics
NPI:1235261538
Name:DRY, SHELLI (OTD, MED, OTR/L)
Entity Type:Individual
Prefix:DR
First Name:SHELLI
Middle Name:
Last Name:DRY
Suffix:
Gender:F
Credentials:OTD, MED, OTR/L
Other - Prefix:DR
Other - First Name:MICHELE
Other - Middle Name:
Other - Last Name:DRY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTD, MED, OTR/L
Mailing Address - Street 1:40 LIZA'S CIRCLE
Mailing Address - Street 2:
Mailing Address - City:SIMPSONVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40067
Mailing Address - Country:US
Mailing Address - Phone:502-797-4536
Mailing Address - Fax:502-890-9486
Practice Address - Street 1:40 LIZA'S CIRCLE
Practice Address - Street 2:
Practice Address - City:SIMPSONVILLE
Practice Address - State:KY
Practice Address - Zip Code:40067
Practice Address - Country:US
Practice Address - Phone:502-797-4536
Practice Address - Fax:502-890-9486
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-12
Last Update Date:2016-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYKYR2278174400000X
KYR2278225XP0200X
KY132372225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
No174400000XOther Service ProvidersSpecialist