Individual
SHAY LYNN RAE TASKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
4767 FRANKFORT HWY, RIDGELEY, WV 26753-7772
(304) 738-4045
Mailing address
2177 SWANTON RD, SWANTON, MD 21561-1009
(301) 616-2327
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
09107
MD
225X00000X
Occupational Therapist
Primary
2123
WV
Other
Enumeration date
09/03/2020
Last updated
09/03/2020
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