Individual
SHAUNA MARIE LIBKA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
7 ROCKY MEADOW CT, GREENVILLE, SC 29615-3663
(864) 275-1679
Mailing address
4618 OLD SPARTANBURG RD APT H, TAYLORS, SC 29687-4252
(989) 916-7146
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
4979
SC
Other
Enumeration date
05/03/2023
Last updated
05/03/2023
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