Individual
SUZETTE MARIE SHAFER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
1790 S. FAIRVIEW AVE., DECATUR, IL 62521
(217) 429-2551
Mailing address
142 N KENWOOD ST, ARGENTA, IL 62501-8195
(217) 841-1880
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
057-003139
IL
Other
Enumeration date
09/13/2010
Last updated
09/13/2010
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