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General NPI Number Information
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NPI Number | 1033504113
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Entity Type | Individual
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Provider Name | SHANNON KIBLER OTR/L
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Gender | Female
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Dates
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Enumeration Date | 04/05/2015
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Last Update Date | 04/05/2015
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Provider Practice Location Address
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Address Line | 2101 DEYERLE AVE
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City | HARRISONBURG
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State | VA
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Zip | 22801-8025
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Country | US
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Telephone | 540-765-1539
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Fax |
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Provider Business Mailing Address
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Address Line | 3381 S EAST SIDE HWY
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City | ELKTON
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State | VA
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Zip | 22827-3601
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 0119006361
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License Number State | VA
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