Provider Demographics
NPI:1659868198
Name:SHEA, NATALIA MYERS (MS,OTR/L)
Entity Type:Individual
Prefix:MS
First Name:NATALIA
Middle Name:MYERS
Last Name:SHEA
Suffix:
Gender:F
Credentials:MS,OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:92 MARLBOROUGH ST APT 2
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02116-2056
Mailing Address - Country:US
Mailing Address - Phone:860-977-4526
Mailing Address - Fax:860-977-4526
Practice Address - Street 1:92 MARLBOROUGH ST APT 2
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02116-2056
Practice Address - Country:US
Practice Address - Phone:860-977-4526
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-19
Last Update Date:2018-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10622225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist