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Individual
SHANNON RYBERG
Active
Individual
SHANNON RYBERG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSOTR/L, CLT
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
10253
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10253
DIVISION OF PROFESSIONAL LICENSURE BOARD OF ALLIED HEALTH PROFESSIONALS
MA
01
—
279133
NATIONAL BOARD OF OCCUPATIONAL THERAPY
—
Enumeration date
04/06/2022
Last updated
04/06/2022
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