Individual
MS. BETHANY DAWN SHANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
4343 OAK GROVE BLVD., SAN ANGELO, TX 76904
(325) 942-4000
Mailing address
12124 HIGH TECH AVE., STE. 300, ORLANDO, FL 32817
(800) 774-7785
(877) 217-9271
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
209824
TX
224Z00000X
Occupational Therapy Assistant
3267
NM
Other
Enumeration date
08/03/2015
Last updated
08/03/2015
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