| NPI | 1982975330 |
|---|---|
| Former Name | SHANNON BOUCHER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225XP0200X Occupational Therapist, Pediatrics (Licence: TN OT0000006230) |
| Additional Taxonomies | 225XP0200X Occupational Therapist, Pediatrics (Licence: IL 056009598) |
| 225XP0200X Occupational Therapist, Pediatrics (Licence: LA ott.200700) | |
| Enumeration Date | 2012-01-17 |
| Last Update Date | 2022-03-18 |