Individual
MS. SHANNON SHAY WATKINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
100 PUSH ROOT CT, LANDER, WY 82520-3460
(307) 332-5508
Mailing address
723 S 5TH ST, LANDER, WY 82520-3630
(307) 349-2433
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA-730LP
WY
Other
Enumeration date
03/18/2009
Last updated
03/18/2009
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