MEDICARE: SHANITA DIGBY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	224Z00000X	Occupational Therapy Assistant	OTA-3051	NV

General Provider Information

NPI Number	:	1063368256
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHANITA DIGBY

Provider Business Mailing Address
First Line	:	250 S CITY PKWY UNIT 478
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89106-4629
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	250 S CITY PKWY UNIT 478
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89106-4629
Country	:	US
Telephone Number	:	708-548-5302
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/09/2026
Last Update Date	:	03/09/2026

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Directions to “ SHANITA DIGBY ” Practice Location

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