NPI 1104133099

Suzette Marie Shafer, COTA

Practitioner Occupational Therapy Assistant Decatur, IL

Practice location

Address: 1790 S. Fairview Ave., Decatur, IL 62521
Phone: (217) 429-2551
Mailing address: 142 N Kenwood St, Argenta, IL 62501-8195

Registered specialties

Occupational Therapy Assistant Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 224Z00000X Licence 057-003139 (IL)

Other Occupational Therapy Assistant providers in Illinois →

Registry record

NPI: 1104133099
Entity type: Individual
Sex (as registered): Female
NPI issued: 13 Sep 2010
Record last updated: 13 Sep 2010

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.