Individual
SHANNON HENKEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
27 MURRAY AVE, WATERFORD, NY 12188-1625
(518) 817-1491
Mailing address
3 SPRUCEWOOD CT, WATERFORD, NY 12188-1256
(518) 817-1491
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
008970
NY
Other
Enumeration date
05/12/2016
Last updated
09/09/2023
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