Individual
ANGELA KAY SHANKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
303 N HURSTBOURNE PKWY, SUITE 200, LOUISVILLE, KY 40222-5185
(502) 412-5847
Mailing address
5230 REGIMENTAL BANNER DR, GRAND BLANC, MI 48439-8731
(810) 265-3531
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
5202007492
MI
Other
Enumeration date
09/12/2012
Last updated
10/05/2012
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