Provider Demographics
NPI:1750328571
Name:RAU, SHELLEY B (OTR/L, CHT)
Entity type:Individual
Prefix:
First Name:SHELLEY
Middle Name:B
Last Name:RAU
Suffix:
Gender:F
Credentials:OTR/L, CHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:395 COUNTY RD
Mailing Address - Street 2:
Mailing Address - City:TURNER
Mailing Address - State:ME
Mailing Address - Zip Code:04282-4208
Mailing Address - Country:US
Mailing Address - Phone:207-225-5222
Mailing Address - Fax:
Practice Address - Street 1:395 COUNTY RD
Practice Address - Street 2:
Practice Address - City:TURNER
Practice Address - State:ME
Practice Address - Zip Code:04282-4208
Practice Address - Country:US
Practice Address - Phone:207-225-5222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-01
Last Update Date:2010-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEOT31225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME292280099Medicaid
ME041357OtherANTHEM BCBS
MEMM9189Medicare PIN
ME041357OtherANTHEM BCBS
MEUX1061Medicare PIN