MEDICARE: SHANNON LEE TODARO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225X00000X	Occupational Therapist	12028	NC
2	225X00000X	Occupational Therapist	5328	SC

General Provider Information

NPI Number	:	1114401205
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHANNON LEE TODARO

Provider Business Mailing Address
First Line	:	320 CARTHAGE CT
Second Line	:
City	:	DURHAM
State	:	NC
Zip	:	27703-7730
Country	:	US
Telephone Number	:	401-644-7481
Fax Number	:

Provider Business Practice Location Address
First Line	:	311 GARDEN AT NORTH HILLS ST
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27609-2662
Country	:	US
Telephone Number	:	984-238-1286
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/24/2018
Last Update Date	:	01/20/2026

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Directions to “ SHANNON LEE TODARO ” Practice Location

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