Individual
MS. SHANNON DIESTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
2423 S BELL BLVD, CEDAR PARK, TX 78613-4753
(512) 827-3601
(512) 777-5042
Mailing address
PO BOX 171078, AUSTIN, TX 78717-0040
(512) 827-3601
(512) 777-5042
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
122512
TX
225XP0200X
Pediatric Occupational Therapist
Primary
122512
TX
Other
Enumeration date
03/29/2022
Last updated
03/29/2022
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