Provider Demographics
NPI:1023614666
Name:SHIPPER, CHAYA (OTR/L)
Entity type:Individual
Prefix:
First Name:CHAYA
Middle Name:
Last Name:SHIPPER
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 1:1 TAMMY RD
Mailing Address - Street 2:
Mailing Address - City:SPRING VALLEY
Mailing Address - State:NY
Mailing Address - Zip Code:10977-1317
Mailing Address - Country:US
Mailing Address - Phone:845-422-7071
Mailing Address - Fax:
Practice Address - Street 1:1 TAMMY RD
Practice Address - Street 2:
Practice Address - City:SPRING VALLEY
Practice Address - State:NY
Practice Address - Zip Code:10977-1317
Practice Address - Country:US
Practice Address - Phone:845-422-7071
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-09
Last Update Date:2020-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist