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General NPI Number Information
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NPI Number | 1386779197
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Entity Type | Individual
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Provider Name | DEIDRE SHUMAKER
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Gender | Female
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Dates
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Enumeration Date | 02/22/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 3 WESTERN HILLS DR
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City | PARKERSBURG
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State | WV
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Zip | 26105-8122
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Country | US
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Telephone | 304-420-1300
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Fax |
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Provider Business Mailing Address
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Address Line | 616 6TH ST
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City | MARIETTA
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State | OH
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Zip | 45750-1914
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Country | US
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Telephone | 440-667-1837
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 1163
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License Number State | WV
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