Provider Demographics
NPI:1659004026
Name:MARR, SHAUNA K (OTD, OTR/L)
Entity Type:Individual
Prefix:DR
First Name:SHAUNA
Middle Name:K
Last Name:MARR
Suffix:
Gender:F
Credentials:OTD, OTR/L
Other - Prefix:MS
Other - First Name:SHAUNA
Other - Middle Name:K
Other - Last Name:ROCHA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTD, OTR/L
Mailing Address - Street 1:7562 ASPEN COLOR ST
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89139-5696
Mailing Address - Country:US
Mailing Address - Phone:602-370-7011
Mailing Address - Fax:
Practice Address - Street 1:3101 W CHARLESTON BLVD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89102-1931
Practice Address - Country:US
Practice Address - Phone:702-831-6670
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-05
Last Update Date:2024-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist