Shelby Lee Clark, OTR/L – Occupational Therapist

Key facts

NPI: 1023511409
Entity type: Individual (NPI type 1)
Primary specialty: Occupational Therapist 225X00000X
License: OT010084 (OH)
Practice address: 205 Nolan Pkwy
Archbold, OH 43502-8404
Phone: (419) 204-0833
NPI assigned: Mar 13, 2018
Sex: Female
Sole proprietor: Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Specialized Speech Technologies, Inc. Speech-Language Pathologist · Columbus, OH · NPI 1629192612

NPD (past)

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): No

State licenses

License	State	Type	Specialty
OT010084	OH	MD	Occupational Therapist

Practice roles

Organization	Specialty	Status	New patients
Specialized Speech Technologies, Inc.		Past since Dec 18, 2008	Accepting new patients

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Occupational Therapist	225X00000X	OT010084	OH	Yes

Addresses

Primary practice location

205 Nolan Pkwy
Archbold, OH 43502-8404

Mailing address

534 Carolyn Dr
Delphos, OH 45833-1347
Phone (419) 204-0833

Other identifiers

Identifier	Type	State	Issuer
OT010084	Other	OH	OTPTAT BOARD

Other providers in Archbold, OH

All providers in Archbold, OH · Occupational Therapist in Ohio

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 5, 2020. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.