Healthcare Provider Details

I. General information

NPI: 1689463614
Provider Name (Legal Business Name): SHANNON STOHLMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/05/2025
Last Update Date: 05/05/2025
Certification Date: 05/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22 S ADAMS ST
DENVER CO
80209-2908
US

IV. Provider business mailing address

225 FLAT RAIL TRL
CARY NC
27511-3363
US

V. Phone/Fax

Practice location:
  • Phone: 303-399-1146
  • Fax:
Mailing address:
  • Phone: 919-949-1403
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT.0008002
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: