Provider Demographics
NPI:1831715358
Name:VILLOTA, SHEREYLYNNE (OTA)
Entity type:Individual
Prefix:
First Name:SHEREYLYNNE
Middle Name:
Last Name:VILLOTA
Suffix:
Gender:F
Credentials:OTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2555 E 12TH ST APT 6H
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-5032
Mailing Address - Country:US
Mailing Address - Phone:347-698-0037
Mailing Address - Fax:
Practice Address - Street 1:2555 E 12TH ST APT 6H
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-5032
Practice Address - Country:US
Practice Address - Phone:347-698-0037
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-20
Last Update Date:2020-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant