SHELLENE CLEMENTS

FORT WAYNE, IN
NPI1952073918
Former NameSHELLENE SQUIRES
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy224Z00000X Occupational Therapy Assistant
(Licence: IN  32003195A)
Enumeration Date2021-09-29
Last Update Date2021-09-29
Business Address
SHELLENE CLEMENTS COTA
10445 DUPONT OAKS BLVD
FORT WAYNE, IN 46845-8792
Phone number: 260-471-4770
Mailing Address
SHELLENE CLEMENTS COTA
PO BOX 207
ASHLEY, IN 46705-0207
Phone number: 260-687-1566
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