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Individual

SHANNON SHABNAM SHAFIE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
OTR

Contact information

Practice address
1640 REDSTONE CENTER DR, SUITE 200, PARK CITY, UT 84098-7605
(888) 800-8744
Mailing address
28 COBBLESTONE CT, SAN RAMON, CA 94583-1754
(925) 487-0997

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
0797
NV

Other

Enumeration date
05/07/2007
Last updated
07/08/2007
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