Individual provider · Type 1 NPI

Shane Michael Disheaux, COTA

Occupational Therapy Assistant · Fort Wayne, IN

NPI number 1508063645 Active

Practice location

2827 Northgate Blvd
Fort Wayne, IN 46835-2903

Call (260) 492-1498 Map

Fax (260) 492-1674

Mailing address

5305 Woodway Dr
Fort Wayne, IN 46835-3676

Specialties and licenses

TaxonomyCodeLicense
Occupational Therapy Assistant Primary 224Z00000X32001345A (IN)

Occupational Therapy Assistant: An occupational therapy assistant is a person who has graduated from an occupational therapy assistant program accredited by the Accreditation Council for Occupational Therapy Education (ACOTE) or predecessor organizations, has successfully completed a period of supervised fieldwork experience required by the accredited occupational therapy assistant program, has passed a nationally recognized entry-level examinatio…

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About NPI 1508063645

Shane Michael Disheaux, COTA's National Provider Identifier is 1508063645, issued on Jul 2, 2007. The primary taxonomy on file is Occupational Therapy Assistant (224Z00000X), and the practice location is in Fort Wayne, IN. The record was last updated on Jul 8, 2007.