Provider Demographics
NPI:1689900250
Name:THRASH, SHELBY SHIELDS (OTR/L, CLT)
Entity Type:Individual
Prefix:MRS
First Name:SHELBY
Middle Name:SHIELDS
Last Name:THRASH
Suffix:
Gender:F
Credentials:OTR/L, CLT
Other - Prefix:MISS
Other - First Name:SHELBY
Other - Middle Name:A
Other - Last Name:SHIELDS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OT
Mailing Address - Street 1:125 BELLE CT
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:MS
Mailing Address - Zip Code:39110-6928
Mailing Address - Country:US
Mailing Address - Phone:601-497-7855
Mailing Address - Fax:
Practice Address - Street 1:125 BELLE CT
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:MS
Practice Address - Zip Code:39110-6928
Practice Address - Country:US
Practice Address - Phone:601-497-7855
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-11-02
Last Update Date:2015-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist