Provider Demographics
NPI:1366177388
Name:BUSSIE, SHAYLA (OTR/L)
Entity type:Individual
Prefix:
First Name:SHAYLA
Middle Name:
Last Name:BUSSIE
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 1:9106 PINE VIEW LN
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:MD
Mailing Address - Zip Code:20735-3229
Mailing Address - Country:US
Mailing Address - Phone:301-868-2930
Mailing Address - Fax:301-356-9047
Practice Address - Street 1:1051 BRIGHTSEAT RD
Practice Address - Street 2:
Practice Address - City:LANDOVER
Practice Address - State:MD
Practice Address - Zip Code:20785-3738
Practice Address - Country:US
Practice Address - Phone:240-487-4400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-22
Last Update Date:2022-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty