Individual
SHANNON MUMPER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
450 NEW MARKET BLVD STE 3, BOONE, NC 28607-5501
(828) 355-9584
(828) 355-9689
Mailing address
450 NEW MARKET BLVD STE 3, BOONE, NC 28607-5501
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
13474
NC
225X00000X
Occupational Therapist
13474
NC
225X00000X
Occupational Therapist
—
—
Other
Enumeration date
08/28/2020
Last updated
03/11/2021
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