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General NPI Number Information
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NPI Number | 1679780175
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Entity Type | Individual
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Provider Name | SHANNON LEVANDOWSKI OT
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Gender | Female
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Dates
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Enumeration Date | 05/16/2007
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Last Update Date | 03/17/2018
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Provider Practice Location Address
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Address Line | 11508 PROMENADE RD
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City | FRISCO
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State | TX
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Zip | 75035-6333
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Country | US
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Telephone | 414-698-8298
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Fax |
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Provider Business Mailing Address
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Address Line | 11508 PROMENADE RD
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City | FRISCO
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State | TX
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Zip | 75035-6333
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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 | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number | 056006691
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number | 4129026
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License Number State | WI
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