Individual
MS. RONNETTA FAYE SHAKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
2119 E NATIONAL HWY, WASHINGTON, IN 47501-4507
(812) 254-3301
(812) 257-0039
Mailing address
304 E RACE ST, ODON, IN 47562-1420
(812) 636-8530
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
32000834A
IN
Other
Enumeration date
07/02/2007
Last updated
07/08/2007
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