Individual
SHELLI SIEWAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
6410 21ST AVE W, BRADENTON, FL 34209-7854
(941) 798-8311
Mailing address
3115 48TH AVENUE DR E, BRADENTON, FL 34203-3976
(941) 592-8982
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA11064
FL
Other
Enumeration date
07/20/2023
Last updated
07/20/2023
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