Individual
SHANNON DENISE RICHARDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
305 GRAYBILL RD, NORTH AUGUSTA, SC 29860
(803) 278-4272
Mailing address
305 GRAYBILL RD, NORTH AUGUSTA, SC 29860
(803) 278-4272
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
3780
SC
Other
Enumeration date
09/05/2018
Last updated
09/05/2018
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