Provider Demographics
NPI:1417258021
Name:ESSE, SHIRLEY ANN (OTR)
Entity Type:Individual
Prefix:MS
First Name:SHIRLEY
Middle Name:ANN
Last Name:ESSE
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:337 SW CHERRYHILL RD
Mailing Address - Street 2:
Mailing Address - City:PORT SAINT LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34953-6235
Mailing Address - Country:US
Mailing Address - Phone:586-206-0837
Mailing Address - Fax:
Practice Address - Street 1:337 SW CHERRYHILL RD
Practice Address - Street 2:
Practice Address - City:PORT SAINT LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34953-6235
Practice Address - Country:US
Practice Address - Phone:586-206-0837
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-11-12
Last Update Date:2014-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT12838225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist