Provider Demographics
NPI:1205235470
Name:SHELOW, DONNA DREYER (OTR)
Entity type:Individual
Prefix:
First Name:DONNA
Middle Name:DREYER
Last Name:SHELOW
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 1:1248 FORSYTHE DR
Mailing Address - Street 2:
Mailing Address - City:FORT WASHINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:19034-1744
Mailing Address - Country:US
Mailing Address - Phone:215-628-2714
Mailing Address - Fax:
Practice Address - Street 1:1248 FORSYTHE DR
Practice Address - Street 2:
Practice Address - City:FORT WASHINGTON
Practice Address - State:PA
Practice Address - Zip Code:19034-1744
Practice Address - Country:US
Practice Address - Phone:215-628-2714
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-13
Last Update Date:2014-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC-000936-L225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist