Individual
SHANNON HOLMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L, BCP
Contact information
Practice address
2449 N TENAYA WAY UNIT 34991, LAS VEGAS, NV 89128-9995
(702) 970-9242
Mailing address
2449 N TENAYA WAY UNIT 34991, LAS VEGAS, NV 89128-9995
(702) 970-9242
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
0046
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003402345
—
NV
Enumeration date
10/10/2006
Last updated
06/01/2022
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