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General NPI Number Information
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NPI Number | 1699397257
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Entity Type | Individual
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Provider Name | SHELBY LYNN MALSBURY
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Gender | Female
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Dates
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Enumeration Date | 05/17/2020
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Last Update Date | 05/17/2020
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Provider Practice Location Address
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Address Line | 100 LONG A COMING LN
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City | BERLIN
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State | NJ
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Zip | 08009-1964
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Country | US
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Telephone | 856-322-3600
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Fax |
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Provider Business Mailing Address
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Address Line | 234 WASHINGTON TER
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City | AUDUBON
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State | NJ
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Zip | 08106-1628
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Country | US
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Telephone |
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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 | 46TR00805600
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License Number State | NJ
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