Shane Michael Disheaux in Fort Wayne - Occupational Therapy Assistant
Shane Michael Disheaux - NPI 1508063645
Shane Michael Disheaux is a Occupational Therapy Assistant in Fort Wayne, Indiana. Shane Michael Disheaux practices all healthcare services and medical treatments related to Occupational Therapy Assistant. The NPI Number for Shane Michael Disheaux is 1508063645. The last update date is 2007-07-08.
Shane Michael Disheaux's current location address is 5305 Woodway Dr, Fort Wayne, Indiana. You can contact this provider via phone number 2604922027 and fax number 2604921674. The mailing address for Shane Michael Disheaux is 5305 Woodway Dr, Fort Wayne, Indiana. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Shane Michael Disheaux |
|---|---|
| Address | 5305 Woodway Dr, Fort Wayne, Indiana |
| Phone Number | 2604922027 |
| Fax Number | 2604921674 |
| Sole Proprietor | N |
| Credentials | COTA |
NPI Number Detail
| NPI Number | 1508063645 |
|---|---|
| Provider Enumeration Date | 2007-07-02 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 5305 Woodway Dr |
|---|---|
| City | Fort Wayne |
| State | Indiana (IN) |
| Post Code | 468353676 |
| Phone Number | 2604922027 |
| Fax Number | 2604921674 |
Provider's Primary Taxonomy Detail
| Speciality | Occupational Therapy Assistant |
|---|---|
| Taxonomy | 224Z00000X |
| Licence No | 32001345A |
|
Definition: An occupational therapy assistant is a person who has graduated from an occupational therapy assistant program accredited by the Accreditation Council for Occupational Therapy Education (ACOTE) or predecessor organizations, has successfully completed |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 1555-656 | IN | -- |
Post Comment/ Review Below
What is the Shane Michael Disheaux's 1508063645?
The Shane Michael Disheaux's NPI (National Provider Identifier) Number is 1508063645. This unique 10-digit identification number is assigned to health care providers by the Centers for Medicare & Medicaid Services (CMS).
Can you provide the Shane Michael Disheaux's physical address?
The Shane Michael Disheaux is physically located at 5305 Woodway Dr, in the city of Fort Wayne, IN, with the postal code 468353676.
What is Shane Michael Disheaux's primary area of medical expertise, and what taxonomy classification code corresponds to this specialized field?
The primary area of medical expertise for Shane Michael Disheaux is Occupational Therapy Assistant, and the corresponding taxonomy classification code for this specialized field is 224Z00000X.
On what date did the Centers for Medicare & Medicaid Services issue the 1508063645 to Shane Michael Disheaux?
The Shane Michael Disheaux received its 1508063645 assignment from the Centers for Medicare & Medicaid Services on 2007-07-02.
As of what date was the information regarding Shane Michael Disheaux, such as address, specialty, and other details, last verified and confirmed to be up-to-date?
The information related to Shane Michael Disheaux, including its address, specialty, and other relevant details, was last verified and confirmed to be up-to-date on 2007-07-08.
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