Individual
SHANNA HERRON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
2309 LA HARVE DR, LAS VEGAS, NV 89106-1947
(702) 275-6031
Mailing address
2309 LA HARVE DR, LAS VEGAS, NV 89106-1947
(702) 275-6031
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
12-1154
NV
Other
Enumeration date
08/21/2012
Last updated
08/21/2012
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