Individual
SHANNON WATSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
360 WOODRUFF RD STE B, GREENVILLE, SC 29607-3697
(803) 929-7408
Mailing address
PO BOX 168, CRYSTAL SPRINGS, MS 39059-0168
(850) 588-9641
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
6195
SC
Other
Enumeration date
08/30/2021
Last updated
03/31/2023
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