Individual
MRS. SHELLY LYNN FLANIGAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
170 ISLAND VIEW DR, LAKEPORT, CA 95453-6456
(618) 204-1624
Mailing address
170 ISLAND VIEW DR, LAKEPORT, CA 95453-6456
(618) 204-1624
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
057003350
IL
224Z00000X
Occupational Therapy Assistant
Primary
OTA3657
CA
Other
Enumeration date
05/22/2012
Last updated
04/20/2017
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