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Individual

MS. SHANNON N KING

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
COTA/L

Contact information

Practice address
2500 SHALLOWFORD RD NE, APT 4423, ATLANTA, GA 30345-1226
(404) 394-2688
Mailing address
2500 SHALLOWFORD RD NE, APT 4423, ATLANTA, GA 30345-1226
(404) 394-2688

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA001154
GA

Other

Enumeration date
06/16/2011
Last updated
06/16/2011
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