Individual
SHANNAN KING LINDHJEM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
255 SOUTH E BLVD, PETERSBURG, VA 23805-2700
(804) 732-0510
Mailing address
4280 STEGER CREEK DR, POWHATAN, VA 23139-5629
(804) 241-8629
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
0131000859
VA
Other
Enumeration date
09/03/2024
Last updated
09/03/2024
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