Individual
SHANNON LOGAN SOBIERAJ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
412 RED HILL AVE STE 1, SAN ANSELMO, CA 94960-2468
(415) 457-4409
Mailing address
183 TAMALPAIS RD, FAIRFAX, CA 94930-1521
(415) 531-4331
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
13631
CA
Other
Enumeration date
07/25/2013
Last updated
07/25/2013
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