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Individual

MRS. SHANA RENEE ROBERTS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OTR

Contact information

Practice address
36759 ROCKSPRINGS RD, POMEROY, OH 45769-9730
(740) 992-6606
(740) 992-2678
Mailing address
PO BOX 473, GALLIPOLIS FERRY, WV 25515-0473
(304) 675-3944

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
05819
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0410817
OH
Enumeration date
06/20/2007
Last updated
07/08/2007
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