Provider Demographics
NPI:1346445723
Name:MULLIGAN, SHELLEY ELIZABETH (PHD, OTR)
Entity Type:Individual
Prefix:PROF
First Name:SHELLEY
Middle Name:ELIZABETH
Last Name:MULLIGAN
Suffix:
Gender:F
Credentials:PHD, OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 ROCKY LN
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NH
Mailing Address - Zip Code:03824-1947
Mailing Address - Country:US
Mailing Address - Phone:603-862-3528
Mailing Address - Fax:
Practice Address - Street 1:4 LIBRARY WAY
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NH
Practice Address - Zip Code:03824-3520
Practice Address - Country:US
Practice Address - Phone:603-862-3528
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH1068225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics