Provider Demographics
NPI:1881404986
Name:MORTON, SHAYNA NICOLE (COTA/L)
Entity type:Individual
Prefix:
First Name:SHAYNA
Middle Name:NICOLE
Last Name:MORTON
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7223 KENTWELL LN
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68516-6774
Mailing Address - Country:US
Mailing Address - Phone:402-499-6772
Mailing Address - Fax:
Practice Address - Street 1:7223 KENTWELL LN
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68516-6774
Practice Address - Country:US
Practice Address - Phone:402-499-6772
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-10
Last Update Date:2025-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1194224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant