Individual
SHANNON CATHERINE SPURRELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTD, OTR/L
Contact information
Practice address
301 SICOMAC AVE, WYCKOFF, NJ 07481-2159
(201) 848-5855
Mailing address
301 SICOMAC AVE, WYCKOFF, NJ 07481-2159
(201) 848-5855
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
46TR01154800
NJ
225XP0200X
Pediatric Occupational Therapist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
025416
OCCUPATIONAL THERAPIST
NY
01
—
444605
NBCOT
NY
01
—
918649306
NYS DRIVER LICENSE
NY
Enumeration date
04/14/2021
Last updated
11/01/2023
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