Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Shannon Polivka, COTA

Individual provider Occupational Therapy Assistant · NPI 1992301790

Shannon Polivka, COTA is an Occupational Therapy Assistant in Fredericksburg, Virginia. Licensed in Virginia. Registered with an NPI since 2020.

Licensed in
VA
In the registry since
2020
What do these letters mean?
COTA — Certified Occupational Therapy Assistant
Delivers treatment under an occupational therapist's direction.

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Practice location Address checks out

11 Dairy Ln
Fredericksburg, VA 22405-2663
Phone: (540) 371-9414
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Occupational Therapy Assistant (primary) Taxonomy 224Z00000X · Licence 0131002318 (VA)

Record details

NPI number1992301790
Entity typeIndividual (Type 1)
GenderFemale
Credentials COTA
Sole proprietorNo
NPI enumeratedDecember 7, 2020
Last updated in NPPESDecember 7, 2020
Certification dateDecember 7, 2020

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