Individual
CHAIRO SHAFFER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
1111 UNIVERSITY DR, EDWARDSVILLE, IL 62025-5589
(618) 692-2273
Mailing address
810 HOLYOAKE RD, EDWARDSVILLE, IL 62025-2315
(618) 980-3696
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
057.004686
IL
Other
Enumeration date
12/12/2017
Last updated
12/12/2017
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