Individual
SHONTAE L. SWANCY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
10790 OLD ST. AUGUSTINE ROAD, JACKSONVILLE, FL 32257
(904) 262-2286
Mailing address
2222 SULLIVAN TRL, EASTON, PA 18040-7958
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA 10154
FL
Other
Enumeration date
12/13/2006
Last updated
07/08/2007
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