Individual
SUSAN MANUELA SHUMATE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
1505 HARPER BLVD SW, PALM BAY, FL 32908-6267
(321) 208-3455
Mailing address
1505 HARPER BLVD SW, PALM BAY, FL 32908-6267
(321) 208-3455
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA12699
FL
Other
Enumeration date
05/06/2014
Last updated
05/06/2014
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