Individual
TATYANA SHOSTAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
110 SUMMIT HILLS DR, SPARTANBURG, SC 29307-1532
(864) 591-2222
Mailing address
2012 SHINNECOCK PT APT 204, SPARTANBURG, SC 29301-6617
(413) 302-4237
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
6715
SC
225X00000X
Occupational Therapist
OTL14671
MA
Other
Enumeration date
02/20/2023
Last updated
12/17/2024
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