Individual
SHANNON MA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTD
Contact information
Practice address
461 RIVER RD, ANDOVER, MA 01810-4349
(650) 709-9009
Mailing address
45 FRANKLIN ST # 1, SOMERVILLE, MA 02145-4227
(650) 709-9009
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
OTL15592
MA
Other
Enumeration date
01/12/2026
Last updated
01/12/2026
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