Individual
SHEA POWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
530 SPARKMAN ST SW, HARTSELLE, AL 35640-3120
(256) 585-5925
Mailing address
530 SPARKMAN ST SW, HARTSELLE, AL 35640-3120
(256) 585-5925
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
3771
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3771
ALABAMA BOARD OF OCCUPATIONAL THERAPY
AL
Enumeration date
04/10/2020
Last updated
04/10/2020
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