Healthcare Provider Details

I. General information

NPI: 1982523973
Provider Name (Legal Business Name): SHALANIE COTTON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/13/2026
Last Update Date: 07/13/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4411 SUMMIT BRIDGE RD
MIDDLETOWN DE
19709-9549
US

IV. Provider business mailing address

24 SHALE RD
DOVER DE
19904-3685
US

V. Phone/Fax

Practice location:
  • Phone: 302-897-9822
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMC-0005079
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: