Individual
SHANNON CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
2280 IVY RD, CHARLOTTESVILLE, VA 22903-4977
(434) 243-0311
Mailing address
PO BOX 9007, CHARLOTTESVILLE, VA 22906-9007
(434) 295-1000
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
—
—
Other
Enumeration date
02/27/2024
Last updated
02/27/2024
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