Individual
MISS KRISTINA SHAMO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
250 INTERNATIONAL PKWY STE 260, LAKE MARY, FL 32746-5022
(800) 806-6026
Mailing address
1200 W MONROE ST APT 715, CHICAGO, IL 60607-2549
(248) 506-4732
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056007759
IL
Other
Enumeration date
07/18/2008
Last updated
07/18/2008
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