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General NPI Number Information
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NPI Number | 1902619125
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Entity Type | Individual
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Provider Name | MOHINI N SHAH OTR/L
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Gender | Female
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Dates
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Enumeration Date | 01/30/2025
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Last Update Date | 01/31/2025
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Provider Practice Location Address
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Address Line | 100 GLENHAVEN DR
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City | ALTON
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State | IL
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Zip | 62002-6759
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Country | US
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Telephone | 618-462-1500
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Fax |
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Provider Business Mailing Address
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Address Line | 4925 BOAT LANDING DR
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City | SAINT AUGUSTINE
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State | FL
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Zip | 32092-3698
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Country | US
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Telephone | 904-671-2207
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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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