Individual
SUSAN M SHANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
7985 KNIGHT RD, GAINESVILLE, GA 30506-6427
(770) 781-4899
Mailing address
7330 PINE VALLEY RD, CUMMING, GA 30041-8150
(732) 598-3630
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
46TR00412900
NJ
225X00000X
Occupational Therapist
Primary
OT006602
GA
225X00000X
Occupational Therapist
OT006602
—
Other
Enumeration date
08/25/2007
Last updated
09/27/2022
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