Individual provider · Type 1 NPI

Loretta Maree Shannon, OTR/L

Occupational Therapist · Supply, NC

NPI number 1679155683 Active

Practice location

58 Physicians Dr NW Ste 106
Supply, NC 28462-4216

Call (910) 329-4444 Map

Fax (910) 406-4111

Mailing address

307 Airlie Vista Ln
Surf City, NC 28445-0109

Specialties and licenses

TaxonomyCodeLicense
Occupational Therapist Primary 225X00000X2076 (NC)

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 1679155683

Loretta Maree Shannon, OTR/L's National Provider Identifier is 1679155683, issued on Apr 28, 2021. The primary taxonomy on file is Occupational Therapist (225X00000X), and the practice location is in Supply, NC. The record was last updated on Aug 31, 2026.