Individual
SHANNON WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
403 GOLF VIEW LANE, HIGHLAND HEIGHTS, OH 44143
(440) 231-4222
Mailing address
402 GOLFVIEW LN, HIGHLAND HEIGHTS, OH 44143-4414
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
007485
OH
Other
Enumeration date
06/11/2021
Last updated
06/11/2021
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