Individual provider · Type 1 NPI

Shannon Forman

Occupational Therapist · Phoenix, AZ

NPI number 1407424823 Active

Practice location

7654 N 19th Ave
Phoenix, AZ 85021-7025

Call (602) 771-5400 Map

Mailing address

1469 E Douglas St
Casa Grande, AZ 85122-1745

Other practice locations

  • 1469 E Douglas St, Casa Grande, AZ 85122-1745 · (516) 398-7478

Specialties and licenses

TaxonomyCodeLicense
Occupational Therapist Primary 225X00000XOTH-009316 (AZ)

Occupational Therapist: An occupational therapist is a person who has graduated from an entry-level occupational therapy program accredited by the Accreditation Council for Occupational Therapy Education (ACOTE) or predecessor organizations, or approved by the World Federation of Occupational Therapists (WFOT), or an equivalent international occupational therapy education program; has successfully completed a period of supervised fieldwork…

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About NPI 1407424823

Shannon Forman's National Provider Identifier is 1407424823, issued on Jun 13, 2021. The primary taxonomy on file is Occupational Therapist (225X00000X), and the practice location is in Phoenix, AZ. The record was last updated on Oct 16, 2024.