Individual
HALEY SHANNON DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
4550 SHENANDOAH AVE NW, ROANOKE, VA 24017-4749
(540) 982-2860
(540) 342-7241
Mailing address
5810 CRISPIN ST APT 2H, ROANOKE, VA 24019-6092
(817) 776-7163
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
0131002593
VA
Other
Enumeration date
12/05/2022
Last updated
12/05/2022
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