Individual
ANGELA MARIE SHANNAHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
2251 E PARIS AVE SE, GRAND RAPIDS, MI 49546-2431
(616) 447-7799
Mailing address
3310 S CREEK DR SE APT 304, KENTWOOD, MI 49512-3042
(734) 634-9813
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5201012919
MI
Other
Enumeration date
06/05/2022
Last updated
06/05/2022
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