Provider Demographics
NPI:1942368113
Name:HUNSUCKER, SHELLEY MARIE (OTR)
Entity Type:Individual
Prefix:MRS
First Name:SHELLEY
Middle Name:MARIE
Last Name:HUNSUCKER
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3107 COUNTY ROAD 73
Mailing Address - Street 2:
Mailing Address - City:MIDLAND CITY
Mailing Address - State:AL
Mailing Address - Zip Code:36350-4205
Mailing Address - Country:US
Mailing Address - Phone:334-983-9959
Mailing Address - Fax:
Practice Address - Street 1:100 W LAKE PROFESSIONAL PARK STE 5
Practice Address - Street 2:
Practice Address - City:GENEVA
Practice Address - State:AL
Practice Address - Zip Code:36340-1200
Practice Address - Country:US
Practice Address - Phone:334-684-3919
Practice Address - Fax:334-684-2394
Is Sole Proprietor?:No
Enumeration Date:2006-12-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2433225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist