Most Relevant Information
Provider Data
| NPI Number: | 1003273715 |
| Provider Name: | SHANNON CORREA |
| Entity Type: | Individual |
| Taxonomy Code: | 225X00000X |
| Specialty: | Occupational Therapist |
| License Number: | 3360 |
Most Important Dates
| Enumeration Date: | 01/26/2016 |
| Last Updated: | 01/26/2016 |
Provider Practice Location
13022 CENTRAL AVE UNIT 403
HAWTHORNE
CA
902505898
Practice Location Phone/Fax
| Phone: | 3109959522 |
| Fax: |
Provider Mailing Location
13022 CENTRAL AVE UNIT 403
HAWTHORNE
CA
902505898
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |