Provider Demographics
NPI:1215053319
Name:SHELHAMER, AMY W (OTR)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:W
Last Name:SHELHAMER
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:123 CHURCH WAY
Mailing Address - Street 2:
Mailing Address - City:CANONSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15317-1341
Mailing Address - Country:US
Mailing Address - Phone:724-746-1139
Mailing Address - Fax:
Practice Address - Street 1:3590 WASHINGTON PIKE
Practice Address - Street 2:
Practice Address - City:BRIDGEVILLE
Practice Address - State:PA
Practice Address - Zip Code:15017-1047
Practice Address - Country:US
Practice Address - Phone:412-257-2474
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC008789225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist