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General NPI Number Information
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NPI Number | 1164189601
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Entity Type | Individual
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Provider Name | STEPHANIE C SHEYNERMAN OTR/L
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Gender | Female
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Dates
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Enumeration Date | 11/18/2021
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Last Update Date | 11/18/2021
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Provider Practice Location Address
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Address Line | 1514 CLEVELAND AVE STE 101-B
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City | EAST POINT
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State | GA
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Zip | 30344-6965
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Country | US
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Telephone | 678-322-8255
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Fax |
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Provider Business Mailing Address
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Address Line | 122 W TRINITY PL APT 1606
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City | DECATUR
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State | GA
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Zip | 30030-3678
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Country | US
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Telephone | 917-704-3688
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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 | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number |
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License Number State |
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