Individual
SHELLY ANN JUAIRE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
7540 N 19TH AVE STE 200, PHOENIX, AZ 85021-7967
(888) 873-4221
(888) 543-2289
Mailing address
3971 PERSHING ST SW, PRIOR LAKE, MN 55372-2373
(952) 440-1975
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
200574
MN
Other
Enumeration date
08/21/2007
Last updated
08/21/2007
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