| NPI | 1760810048 |
|---|---|
| Former Name | SHANNON NICOLE COLLIE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: SC 6119) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: NC 8038) |
| Enumeration Date | 2013-10-23 |
| Last Update Date | 2021-12-07 |