Provider Demographics
NPI:1548978364
Name:SHANDY, DORIE K (OTR/L)
Entity type:Individual
Prefix:
First Name:DORIE
Middle Name:K
Last Name:SHANDY
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 1:4636 SE STUBBS RD
Mailing Address - Street 2:
Mailing Address - City:TECUMSEH
Mailing Address - State:KS
Mailing Address - Zip Code:66542-9734
Mailing Address - Country:US
Mailing Address - Phone:316-210-8030
Mailing Address - Fax:
Practice Address - Street 1:4636 SE STUBBS RD
Practice Address - Street 2:
Practice Address - City:TECUMSEH
Practice Address - State:KS
Practice Address - Zip Code:66542-9734
Practice Address - Country:US
Practice Address - Phone:316-210-8030
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-10
Last Update Date:2022-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist