Provider Demographics
NPI:1568571859
Name:PARSONS, SHANNON
Entity Type:Individual
Prefix:
First Name:SHANNON
Middle Name:
Last Name:PARSONS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:63 SARASOTA CENTER BLVD
Mailing Address - Street 2:#101
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34240-9385
Mailing Address - Country:US
Mailing Address - Phone:941-379-3725
Mailing Address - Fax:
Practice Address - Street 1:63 SARASOTA CENTER BLVD
Practice Address - Street 2:#101
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34240-9385
Practice Address - Country:US
Practice Address - Phone:941-379-3725
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OT10252225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist