Shanell L Black Southall, OT

NPI #1508015843 in Goodlettsville, Tennessee

Provider Information

NPI Number: 1508015843
Entity Type: Individual
Name: Shanell L Black Southall, OT
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Occupational Therapist
Credential: OT
Enumeration Date: Sep 10, 2008
Last Updated: Aug 4, 2021

Practice Location

Address: 9303 PRESTON RUN
City: Goodlettsville
State: Tennessee
ZIP Code: 37072-1942
Phone: (615) 260-2978

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Massage Therapist	225700000X
Occupational Therapist	225X00000X	Primary

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