Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
SHAUNA WALLACE, OTR
ActiveSHAUNA WALLACE, OTR is a Occupational Therapist healthcare provider located in MINONG, Wisconsin. NPI 1033585104 is currently active in the NPPES registry. Verify at CMS.
Occupational Therapist · MINONG, WI
Registration Details
- NPI Number
- 1033585104
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Aug 12, 2015 (10.997549504089 yrs)
- Last Updated
- Sep 21, 2018
- Licenses
-
4861-27 (WI)6369-26 (WI)
Practice Information
- Address
-
N14463 HIGHWAY 53MINONG, WI, 548599483Browse WI providers · Browse ZIP 54859
- Phone
- 7154662297
- Primary Specialty
-
Occupational Therapist
225X00000X
- Additional Specialty
- Occupational Therapist
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.