Individual
SHANNON ELIZABETH HILLESTAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.T.
Contact information
Practice address
1364 CLIFTON RD NE, ATLANTA, GA 30322-1059
(404) 712-7288
(404) 712-7774
Mailing address
2835 BARBARA LN NE, MARIETTA, GA 30062-1432
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT005334
GA
Other
Enumeration date
05/19/2015
Last updated
11/22/2017
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