Individual
MRS. SHANON M FUNKHOUSER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
9070 HARMONY DR STE A, MIDWEST CITY, OK 73130-6257
(405) 455-5582
Mailing address
10700 S MAY AVE APT 126, OKLAHOMA CITY, OK 73170-2576
(405) 885-9141
(580) 323-4509
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
810
OK
Other
Enumeration date
06/05/2007
Last updated
07/12/2021
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