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General NPI Number Information
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NPI Number | 1881299147
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Entity Type | Individual
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Provider Name | JESSICA SHALONGO OTR/L
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Gender | Female
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Dates
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Enumeration Date | 12/03/2020
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Last Update Date | 02/17/2022
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Provider Practice Location Address
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Address Line | 594 VOSHELLS MILL STAR HILL RD
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City | DOVER
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State | DE
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Zip | 19901-7609
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Country | US
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Telephone | 302-697-6117
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Fax |
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Provider Business Mailing Address
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Address Line | 7 FRONT ST
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City | WYOMING
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State | DE
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Zip | 19934-1121
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Country | US
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Telephone | 302-698-4800
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | U1-0012235
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License Number State | DE
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