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Individual

SHAUNA SCEPANIAK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OTR/L

Contact information

Practice address
11800 XEON BLVD NW, COON RAPIDS, MN 55448-2061
(612) 368-3917
(763) 312-2134
Mailing address
885 W TRINI DR, KUNA, ID 83634-1801

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
104869
MN
225X00000X
Occupational Therapist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
231243300
MN
Enumeration date
10/27/2017
Last updated
07/13/2020
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