Individual
SHELLY RAE JENNINGS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
8540 SCARBOROUGH DR STE 200, COLORADO SPRINGS, CO 80920-7513
(719) 314-0151
Mailing address
5027 W MCLELLAN RD, GLENDALE, AZ 85301-4012
(623) 349-2020
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
5391
AZ
Other
Enumeration date
10/07/2014
Last updated
10/07/2014
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