Healthcare Provider Details

I. General information

NPI: 1518208255
Provider Name (Legal Business Name): SHILPA HEMANT DALVI OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/05/2013
Last Update Date: 03/05/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

404 KING SPRINGS VILLAGE PKWY SE
SMYRNA GA
30082-4240
US

IV. Provider business mailing address

516 PARKWAY CIR S
ATLANTA GA
30340-6306
US

V. Phone/Fax

Practice location:
  • Phone: 770-431-0816
  • Fax:
Mailing address:
  • Phone: 863-409-8573
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XG0600X
TaxonomyGerontology Occupational Therapist
License NumberOT5068
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: