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General NPI Number Information
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NPI Number | 1306562467
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Entity Type | Organization
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Legal Business Name | IMAGINATION STATION THERAPY, PLLC
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Dates
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Enumeration Date | 10/19/2022
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Last Update Date | 02/08/2023
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Provider Practice Location Address
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Address Line | 91 LINDSAY LN
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City | MARSHALL
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State | NC
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Zip | 28753-5599
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Country | US
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Telephone | 304-550-7295
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Fax | 800-686-9093
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Provider Business Mailing Address
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Address Line | 91 LINDSAY LN
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City | MARSHALL
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State | NC
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Zip | 28753-5599
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Country | US
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Telephone | 304-550-7295
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Fax | 800-686-9093
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Authorized Official
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Title or Position | OT/OWNER
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Name | SHANNA HUGHES CARTER
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Credential | OTR/L
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Telephone | 304-550-7295
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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 |
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License Number State |
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