Provider Demographics
NPI:1265780829
Name:HANIFF, SHAMICA ANN (OTR/L)
Entity type:Individual
Prefix:MRS
First Name:SHAMICA
Middle Name:ANN
Last Name:HANIFF
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1006 PARKES ST
Mailing Address - Street 2:
Mailing Address - City:MATTHEWS
Mailing Address - State:NC
Mailing Address - Zip Code:28105-5970
Mailing Address - Country:US
Mailing Address - Phone:646-591-6649
Mailing Address - Fax:
Practice Address - Street 1:1006 PARKES ST
Practice Address - Street 2:
Practice Address - City:MATTHEWS
Practice Address - State:NC
Practice Address - Zip Code:28105-5970
Practice Address - Country:US
Practice Address - Phone:646-591-6649
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-29
Last Update Date:2025-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY017154-1225XP0200X
NC17662225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics