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General NPI Number Information
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NPI Number | 1295223709
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Entity Type | Individual
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Provider Name | SHAWNA HUTCHISON
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Gender | Female
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Dates
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Enumeration Date | 04/30/2018
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Last Update Date | 04/30/2018
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Provider Practice Location Address
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Address Line | 3001 E OAKLAND PARK BLVD
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City | FT LAUDERDALE
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State | FL
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Zip | 33306-1806
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Country | US
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Telephone | 954-363-2901
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Fax | 954-363-2902
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Provider Business Mailing Address
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Address Line | 5661 NE 18TH AVE APT 117
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City | FT LAUDERDALE
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State | FL
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Zip | 33334-5972
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Country | US
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Telephone | 417-549-0829
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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 | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number | OTA16083
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License Number State | FL
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