Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MR. SHANNON LANE BROWN, COTA
Active Sole ProprietorOccupational Therapy Assistant · BAY SPRINGS, MS
Registration Details
- NPI Number
- 1578857363
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jun 9, 2011 (14.881050163991 yrs)
- Last Updated
- Jun 9, 2011
- License
-
TA2354 (MS)
- Sole Proprietor
- Yes
Practice Information
- Address
-
43 COUNTY ROAD 1721BAY SPRINGS, MS, 394229804Browse MS providers · Browse ZIP 39422
- Phone
- 6014673476
- Primary Specialty
-
Occupational Therapy Assistant
224Z00000X
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.