Individual
SHANNON L NOFZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, OTR/L
Contact information
Practice address
6120 STADIUM DR STE 100, KALAMAZOO, MI 49009-3022
(269) 372-8555
Mailing address
41894 COUNTY ROAD 653, PAW PAW, MI 49079-9469
(269) 986-3518
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5201007762
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1588642110
—
MI
Enumeration date
12/10/2018
Last updated
12/10/2018
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