Provider Demographics
NPI:1538664768
Name:ABBOTT, SHELLY HELEN
Entity Type:Individual
Prefix:MRS
First Name:SHELLY
Middle Name:HELEN
Last Name:ABBOTT
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:SHELLY
Other - Middle Name:
Other - Last Name:MIAO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:17510 HIDDEN GARDEN LN
Mailing Address - Street 2:
Mailing Address - City:ASHTON
Mailing Address - State:MD
Mailing Address - Zip Code:20861-3651
Mailing Address - Country:US
Mailing Address - Phone:480-559-2607
Mailing Address - Fax:
Practice Address - Street 1:17340 QUAKER LN
Practice Address - Street 2:
Practice Address - City:SANDY SPRING
Practice Address - State:MD
Practice Address - Zip Code:20860-1247
Practice Address - Country:US
Practice Address - Phone:301-924-7500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-28
Last Update Date:2018-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0019XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPhysical Rehabilitation