Individual
SHANNON WEED
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
101 1ST ST, OCONTO, WI 54153-1117
(920) 834-4575
Mailing address
W6444 TWO MILE RD, PORTERFIELD, WI 54159-9343
(715) 923-7374
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
—
—
Other
Enumeration date
08/18/2019
Last updated
08/18/2019
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