Individual
MS. SHANNON FARYADI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
1351 ROBINWOOD RD, GASTONIA, NC 28054-1693
(704) 618-3941
Mailing address
8125 WESTBOURNE DR, CHARLOTTE, NC 28216-1140
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
11628
NC
Other
Enumeration date
04/07/2021
Last updated
06/22/2022
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