Individual
SHANNON MARIE NEWCOMB
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
111 SAVANNAH DAWN CT, MT WASHINGTON, KY 40047-6451
(502) 428-1320
Mailing address
111 SAVANNAH DAWN CT, MT WASHINGTON, KY 40047-6451
(502) 428-1320
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
164370
KY
Other
Enumeration date
08/09/2016
Last updated
08/09/2016
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