Individual
MS. SHAWN ELISE LANGE I
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
1011 MERIDIAN ST, SAULT SAINTE MARIE, MI 49783-2650
(906) 635-1518
Mailing address
3700 S RIVERSIDE DR, SAULT SAINTE MARIE, MI 49783-9505
(906) 440-1440
(909) 635-0970
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
L5201005798
MI
Other
Enumeration date
07/21/2017
Last updated
07/21/2017
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