Shannon E Tyler

Individual provider Active NPI Environmental Modification Occupational Therapy Assistant · Goodview, VA

NPI 1467229153 · NPPES record last updated Dec 4, 2023

Key facts

NPI
1467229153
Entity type
Individual (NPI type 1)
Primary specialty
Environmental Modification Occupational Therapy Assistant 224ZE0001X
Practice address
1681 Blankenship Rd
Goodview, VA 24095-2729
Phone
(540) 521-7447
NPI assigned
Dec 4, 2023
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Environmental Modification Occupational Therapy Assistant 224ZE0001X Yes

Addresses

Primary practice location

1681 Blankenship Rd
Goodview, VA 24095-2729

Mailing address

1681 Blankenship Rd
Goodview, VA 24095-2729
Phone (540) 521-7447

Other providers in Goodview, VA

All providers in Goodview, VA · Environmental Modification Occupational Therapy Assistant in Virginia

Sources for this page

Verify at the official NPI Registry.