Provider Demographics
NPI:1497489777
Name:WALKER, SHELBY (OTR/L)
Entity Type:Individual
Prefix:
First Name:SHELBY
Middle Name:
Last Name:WALKER
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:SHELBY
Other - Middle Name:
Other - Last Name:GREENLUND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:80 TIMBERLAKE LN
Mailing Address - Street 2:
Mailing Address - City:ORMOND BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32174-4254
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8 EAGLE LAKE DR
Practice Address - Street 2:
Practice Address - City:FLAGLER BEACH
Practice Address - State:FL
Practice Address - Zip Code:32136-4382
Practice Address - Country:US
Practice Address - Phone:715-226-1545
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-13
Last Update Date:2022-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT19328225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist