Individual
SHANNON NATSUKO SMALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
50 DEKALB AVE, S2, WHITE PLAINS, NY 10605-1445
(808) 384-1966
Mailing address
50 DEKALB AVE, S2, WHITE PLAINS, NY 10605-1445
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
016436
NY
Other
Enumeration date
08/30/2009
Last updated
10/25/2010
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