Individual
HAZEL SHIPMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
O.T.
Contact information
Practice address
318 B MOORE STREET, LAKE CITY, SC 29560-2551
(843) 394-9799
(843) 394-9899
Mailing address
823 E 10TH ST, HOOPESTON, IL 60942-1541
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
056007918
IL
225X00000X
Occupational Therapist
Primary
3540
SC
Other
Enumeration date
06/11/2009
Last updated
06/11/2009
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