Provider Demographics
NPI:1598412603
Name:CHAINEY-HANCOCK, SHELLI (OTR)
Entity Type:Individual
Prefix:
First Name:SHELLI
Middle Name:
Last Name:CHAINEY-HANCOCK
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:SHELLI
Other - Middle Name:
Other - Last Name:CHAINEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:605 N WEST AVE
Mailing Address - Street 2:
Mailing Address - City:REPUBLIC
Mailing Address - State:MO
Mailing Address - Zip Code:65738-1061
Mailing Address - Country:US
Mailing Address - Phone:417-894-8120
Mailing Address - Fax:
Practice Address - Street 1:4150 W REPUBLIC RD
Practice Address - Street 2:
Practice Address - City:BATTLEFIELD
Practice Address - State:MO
Practice Address - Zip Code:65619-7111
Practice Address - Country:US
Practice Address - Phone:417-881-7800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-08
Last Update Date:2022-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2019011139225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist