Individual
SHANDA DAE BENEMERITO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L, CPAM
Contact information
Practice address
102 E SOUTH ST, RCH REHAB DEPARTMENT, BASSETT, NE 68714-5508
(402) 684-3366
(413) 431-5660
Mailing address
PO BOX 38, 621 NORTH MAIN ST, LONG PINE, NE 69217-0038
(402) 273-3164
(413) 431-5660
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
819
NE
Other
Enumeration date
11/28/2007
Last updated
11/28/2007
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