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Individual

MRS. DEBRA LYNN SHUTTLEWORTH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
COTA/L

Contact information

Practice address
100 HIGH POINT DR, KANE, PA 16735-9704
(814) 837-6706
Mailing address
192 EARL ROAD, ST. MARYS, PA 15857
(814) 834-7921

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OP003628L
PA

Other

Enumeration date
06/19/2012
Last updated
06/19/2012
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