Henley, Shelley

Henley, Shelley is an sole proprietor health care provider with primary practice located at 681 Jerrells Ave , Fort Walton Beach FL 32547-3187. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Developmental Therapist, which is considered as her primary health care specialty. Henley, Shelley can be contacted via phone (850) 797-0550.

Contact Information

Primary practice address
681 Jerrells Ave Fort Walton Beach FL 32547-3187
Phone: (850) 797-0550
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Developmental Therapist 222Q00000X

Profile Details

NPI number 1255658761
LBN Legal business name Henley, Shelley
Credentials ITDS
Entity Individual
Sole proprietor 1 Yes
Enumeration date Apr 23rd, 2010
Last updated Apr 23rd, 2010 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1255658761 NPPES
Florida MEDICAID PENDING

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