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General NPI Number Information
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NPI Number | 1730049503
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Entity Type | Organization
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Legal Business Name | SHIFT WELLNESS LLC
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Dates
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Enumeration Date | 11/14/2025
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Last Update Date | 11/14/2025
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Provider Practice Location Address
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Address Line | 346 QUINNIPIAC ST STE J
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City | WALLINGFORD
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State | CT
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Zip | 06492-4053
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Country | US
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Telephone | 203-679-1587
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Fax |
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Provider Business Mailing Address
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Address Line | 346 QUINNIPIAC ST STE J
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City | WALLINGFORD
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State | CT
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Zip | 06492-4053
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Country | US
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Telephone | 203-679-1587
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JOANNA LYNN PEREZ
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Credential | OT/L
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Telephone | 203-679-1587
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225XP0019X
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Taxonomy Name | Physical Rehabilitation Occupational Therapist
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License Number |
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License Number State |
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