Individual
SHALA DANIELS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
3680 DOLSON CT, CARROLL, OH 43112-9721
(740) 654-0641
Mailing address
112 S PEMBROKE AVE, ZANESVILLE, OH 43701-6349
(740) 683-2289
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA007114
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
105414265-00
—
OH
Enumeration date
12/30/2017
Last updated
12/30/2017
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