Provider Demographics
NPI:1528368131
Name:SHIBAYAMA, EMILY (OTR/L)
Entity Type:Individual
Prefix:MS
First Name:EMILY
Middle Name:
Last Name:SHIBAYAMA
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:MRS
Other - First Name:EMILY
Other - Middle Name:
Other - Last Name:ADORJAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OTR/L
Mailing Address - Street 1:3295 N DRINKWATER BLVD
Mailing Address - Street 2:SUITE 14-15
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85251-6492
Mailing Address - Country:US
Mailing Address - Phone:480-634-5440
Mailing Address - Fax:
Practice Address - Street 1:3295 N DRINKWATER BLVD
Practice Address - Street 2:SUITE 14-15
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85251-6492
Practice Address - Country:US
Practice Address - Phone:480-634-5440
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-10-29
Last Update Date:2010-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ3972225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist