Provider Demographics
NPI:1275815441
Name:SHINNERS, PATRICIA FOSTER (OT)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:FOSTER
Last Name:SHINNERS
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7900 OWEN DR
Mailing Address - Street 2:
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49009-9007
Mailing Address - Country:US
Mailing Address - Phone:269-903-2273
Mailing Address - Fax:269-903-2329
Practice Address - Street 1:7900 OWEN DR
Practice Address - Street 2:
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49009-9007
Practice Address - Country:US
Practice Address - Phone:269-903-2273
Practice Address - Fax:269-903-2329
Is Sole Proprietor?:No
Enumeration Date:2011-09-14
Last Update Date:2011-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5201005379225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist