Jade Shadburn
Individual provider Active NPI Occupational Therapy Assistant · Berkley, MA
NPI 1386175115 · NPPES record last updated Mar 23, 2017
Key facts
- NPI
- 1386175115
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Occupational Therapy Assistant 224Z00000X
- Practice address
- 1 Vary Way
Berkley, MA 02779-1720 - Phone
- (508) 880-0883
- NPI assigned
- Mar 23, 2017
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | Yes |
Addresses
Primary practice location
1 Vary Way
Berkley, MA 02779-1720
Mailing address
1 Vary Way
Berkley, MA 02779-1720
Other providers in Berkley, MA
- Adedayo Pelote
- Alyia Pothemont
- Talia Nicole Roos
- Lauren Mary Rotundo
- Bridgett Ann Sanchez
- Patricia Sittig
- Joyce Ann Souza
- Virginia Starvish
- Debra Wolfer Stowell
- Josephine Swift
All providers in Berkley, MA · Occupational Therapy Assistant in Massachusetts
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 23, 2017. 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.