Individual
MRS. SHADONDA EVETTE BRIGGS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
101 SOUR ST, BECKLEY, WV 25801-3928
(304) 719-9309
Mailing address
101 SOUR ST, BECKLEY, WV 25801-3928
(304) 719-9309
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
7219
NC
224Z00000X
Occupational Therapy Assistant
Primary
C1614
WV
Other
Enumeration date
10/04/2012
Last updated
10/04/2012
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