Shanine Theres Fogle

NPI #1265105175 in Homosassa, Florida

Provider Information

NPI Number: 1265105175
Entity Type: Individual
Name: Shanine Theres Fogle
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Occupational Therapist
Enumeration Date: Jul 27, 2021
Last Updated: Jul 27, 2021

Practice Location

Address: 8477 S SUNCOAST BLVD
City: Homosassa
State: Florida
ZIP Code: 34446-5028
Phone: (352) 382-7214

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Occupational Therapist	225X00000X	Primary

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