Individual
CONSTANCE S SHAFFER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR L
Contact information
Practice address
3915 GOLDEN VALLEY ROAD, COURAGE CENTER, GOLDEN VALLEY, MN 55422-4298
(763) 520-0425
(763) 520-0861
Mailing address
3915 GOLDEN VALLEY ROAD, COURAGE CENTER, GOLDEN VALLEY, MN 55422-4298
(763) 520-0425
(763) 520-0861
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
102152
MN
225XR0403X
Driving and Community Mobility Occupational Therapist
102152
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6411150
MEDICA
—
01
—
76D35SH
BCBS MINNESOTA
—
01
—
HP11422
HEALTHPARTNERS
—
Enumeration date
06/09/2006
Last updated
12/09/2011
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