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General NPI Number Information
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NPI Number | 1699899658
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Entity Type | Individual
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Provider Name | SHELLY A MESURE MS, OTRL
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Gender | Female
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Dates
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Enumeration Date | 03/16/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 956 E RAILROAD AVE STE 201
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City | BRYN MAWR
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State | PA
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Zip | 19010-3831
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Country | US
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Telephone | 215-255-5596
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Fax |
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Provider Business Mailing Address
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Address Line | 262 S 4TH ST
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City | PHILADELPHIA
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State | PA
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Zip | 19106-3721
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Country | US
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Telephone | 215-255-5596
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Fax | 610-527-3220
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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 | OC008617
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License Number State | PA
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