Individual
MRS. SHANNON PLEASANTS LEWIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
901 RIDGE RD, ROXBORO, NC 27573-4511
(336) 599-0106
Mailing address
140 SUMMERLYN PLACE, SEMORA, NC 27343
(336) 234-7080
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
4120
NC
Other
Enumeration date
01/10/2011
Last updated
01/10/2011
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