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NPI Code Detail

MEDICARE: MS. SHANNON FLEMING COTA/L

MEDICARE: MS. SHANNON FLEMING COTA/L
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1224Z00000XOccupational Therapy Assistant0131000282VA

General Provider Information

NPI Number : 1316357353
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. SHANNON FLEMING COTA/L
Provider Business Mailing Address
First Line : 7090 COVENANT WOODS DR
Second Line :
City : MECHANICSVILLE
State : VA
Zip : 23111-7025
Country : US
Telephone Number : 804-569-8697
Fax Number :
Provider Business Practice Location Address
First Line : 7090 COVENANT WOODS DR
Second Line :
City : MECHANICSVILLE
State : VA
Zip : 23111-7025
Country : US
Telephone Number : 804-569-8697
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/29/2014
Last Update Date : 04/29/2014

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Directions to “ MS. SHANNON FLEMING COTA/L” Practice Location

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