Individual
SHANITA ROBERTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
600 W CHELTENHAM AVE, PHILADELPHIA, PA 19126-3045
(215) 927-7300
Mailing address
600 W CHELTENHAM AVE, PHILADELPHIA, PA 19126-3045
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OP010107
PA
Other
Enumeration date
08/18/2022
Last updated
08/18/2022
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