Dicecco, Shelley Smith

Dicecco, Shelley Smith is an individual health care provider with primary practice located at 2669 Osborne Rd Ne , Brookhaven GA 30319-8400. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as her primary health care specialty. Dicecco, Shelley Smith can be contacted via phone (404) 477-7777.

Contact Information

Primary practice address
2669 Osborne Rd Ne Brookhaven GA 30319-8400
Phone: (404) 477-7777
Fax: (404) 477-7000
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X PT006744 Georgia

Profile Details

NPI number 1801834163
LBN Legal business name Dicecco, Shelley Smith
Credentials MSPT
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 2nd, 2006
Last updated Apr 22nd, 2015 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1801834163 NPPES
Georgia MEDICAID 369496714A
Georgia Other 592137

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