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Contact Information

SUZETTE M SHAFER, COTA
1790 S. FAIRVIEW AVE.
DECATUR, IL62521
 Phone: 217-429-2551
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Occupational Therapy Assistant

224Z00000X
Indicates primary specialty

NPI Profile & details for SUZETTE M SHAFER · (Female)

NPI Number 1104133099
Status Active
Credentials COTA (Certified Occupational Therapy Assistant)
Entity Individual
Enumeration date 09/13/2010
Last updated 09/13/2010 - About 16 years ago
Sole proprietor 1 Yes
Identifiers
  • IL License # 057-003139
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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