Individual
SHANNON LEANNE FOSTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS OTR/L
Contact information
Practice address
400 ANN ST NW, GRAND RAPIDS, MI 49504-2052
(810) 610-7588
Mailing address
400 ANN ST NW STE 106A, GRAND RAPIDS, MI 49504-2053
(810) 610-7588
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5201007194
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0
NONE
—
Enumeration date
12/06/2017
Last updated
06/16/2018
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