Individual
SHANNON ELIZABETH WYLIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
300 FLOYD DR, SIKESTON, MO 63801-3960
(573) 472-0397
(573) 472-0409
Mailing address
2037 PEAR TREE CT, APARTMENT 1, CAPE GIRARDEAU, MO 63701-2111
(573) 690-4963
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
2010024922
MO
Other
Enumeration date
08/11/2010
Last updated
08/11/2010
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