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Individual

CARLY BROOKE SHAPIRO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OTR/L

Contact information

Practice address
2385 LAWRENCEVILLE HWY, DECATUR, GA 30033-3168
(770) 789-1017
Mailing address
6506 CANOPY DR, ATLANTA, GA 30328-2892
(770) 789-1017

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
OT007547
GA
225X00000X
Occupational Therapist
Primary
OT007547
GA

Other

Enumeration date
10/15/2019
Last updated
10/16/2019
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