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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

SHANNON WALLACE

Active

SHANNON WALLACE is a Occupational Therapist healthcare provider located in WHITE PINE, Tennessee. NPI 1437707452 is currently active in the NPPES registry. Verify at CMS.

Occupational Therapist · WHITE PINE, TN

Registration Details

NPI Number
1437707452
Provider Type
Individual
Gender
Female
NPI Issued
Sep 3, 2019 (6.9105379874812 yrs)
Last Updated
Sep 3, 2019
License
7143 (TN)

Practice Information

Address
3108 CIRCLE DR
WHITE PINE, TN, 378903306
Browse TN providers · Browse ZIP 37890
Phone
8656747454
Primary Specialty
Occupational Therapist
225200000X
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.