Shauna Wallace, OTR

NPI #1033585104 in Minong, Wisconsin

Provider Information

NPI Number: 1033585104
Entity Type: Individual
Name: Shauna Wallace, OTR
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Occupational Therapist
Credential: OTR
Enumeration Date: Aug 12, 2015
Last Updated: Sep 21, 2018

Practice Location

Address: N14463 HIGHWAY 53
City: Minong
State: Wisconsin
ZIP Code: 54859-9483
Phone: (715) 466-2297

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Occupational Therapy Assistant	224Z00000X
Occupational Therapist	225X00000X	Primary

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