Provider Demographics
NPI:1043453038
Name:SHELTON, BARBARA A (CERTIFIED OCCUPATION)
Entity type:Individual
Prefix:
First Name:BARBARA
Middle Name:A
Last Name:SHELTON
Suffix:
Gender:F
Credentials:CERTIFIED OCCUPATION
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:342 VIRGINIA AVENUE
Mailing Address - Street 2:HEARTLAND REHABILITATION SERVICES OF VIRGINIA, INC.
Mailing Address - City:WYTHEVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24382
Mailing Address - Country:US
Mailing Address - Phone:276-228-6200
Mailing Address - Fax:276-228-9175
Practice Address - Street 1:342 VIRGINIA AVENUE
Practice Address - Street 2:HEARTLAND REHABILITATION SERVICES OF VIRGINIA, INC.
Practice Address - City:WYTHEVILLE
Practice Address - State:VA
Practice Address - Zip Code:24382
Practice Address - Country:US
Practice Address - Phone:276-228-6200
Practice Address - Fax:276-228-9175
Is Sole Proprietor?:No
Enumeration Date:2009-04-07
Last Update Date:2009-04-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CERTIFICATION#104743224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant