Individual
SHANNON HATHAWAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1701 BYRD AVE, RICHMOND, VA 23230-3011
(804) 612-1947
Mailing address
5004 MONUMENT AVE STE 104, RICHMOND, VA 23230-3629
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
0119004953
VA
Other
Enumeration date
12/18/2019
Last updated
12/18/2019
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