Individual
SHANNON RANDALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
2030 WINDWARD LN, GAINESVILLE, GA 30501-7418
(770) 535-8181
Mailing address
125 TOWNPARK DR NW STE 300, KENNESAW, GA 30144-5812
(855) 423-6287
(678) 669-1562
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT006090
GA
Other
Enumeration date
08/03/2015
Last updated
03/17/2018
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