Provider Demographics
NPI:1952933475
Name:ARMAND, SHELBY NICOLE (MOT, OTR/L)
Entity type:Individual
Prefix:
First Name:SHELBY
Middle Name:NICOLE
Last Name:ARMAND
Suffix:
Gender:F
Credentials:MOT, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1711 CLOUGH ST
Mailing Address - Street 2:
Mailing Address - City:BOWLING GREEN
Mailing Address - State:OH
Mailing Address - Zip Code:43402-3421
Mailing Address - Country:US
Mailing Address - Phone:567-208-8141
Mailing Address - Fax:
Practice Address - Street 1:904 ISAAC STREETS DR
Practice Address - Street 2:
Practice Address - City:OREGON
Practice Address - State:OH
Practice Address - Zip Code:43616-3204
Practice Address - Country:US
Practice Address - Phone:567-208-8141
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-12
Last Update Date:2020-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOT010521225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist