Provider Demographics
NPI:1629201348
Name:SHIRLEY, WESLEY TODD (MOT,OTR/L)
Entity Type:Individual
Prefix:MR
First Name:WESLEY
Middle Name:TODD
Last Name:SHIRLEY
Suffix:
Gender:M
Credentials:MOT,OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4733 HUNTERS CROSSING DR
Mailing Address - Street 2:
Mailing Address - City:OLD HICKORY
Mailing Address - State:TN
Mailing Address - Zip Code:37138-1268
Mailing Address - Country:US
Mailing Address - Phone:615-519-3800
Mailing Address - Fax:
Practice Address - Street 1:115 WOODMONT BLVD
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37205-2280
Practice Address - Country:US
Practice Address - Phone:615-519-3800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-27
Last Update Date:2009-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1683225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist