Individual
MRS. KATESSIA LEANN SHELTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
401 E MAIN ST STE 4, JOHNSON CITY, TN 37601-4891
(423) 722-2062
(243) 722-2062
Mailing address
401 E MAIN ST STE 4, JOHNSON CITY, TN 37601-4891
(423) 722-2062
(243) 722-2062
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
2782
TN
Other
Enumeration date
10/04/2016
Last updated
10/04/2016
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