Shannon Lane, COTA/L

NPI #1093089179 in Palmetto, Florida

Provider Information

NPI Number: 1093089179
Entity Type: Individual
Name: Shannon Lane, COTA/L
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Specialist
Credential: COTA/L
Enumeration Date: Mar 7, 2012
Last Updated: Aug 7, 2014

Practice Location

Address: 410 10TH AVE W
City: Palmetto
State: Florida
ZIP Code: 34221-5032
Phone: (941) 722-3582

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary
Occupational Therapy Assistant	224Z00000X

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