Provider Demographics
NPI:1043460983
Name:O'DONNELL, SHANLEY POSSEMATO (MS)
Entity Type:Individual
Prefix:
First Name:SHANLEY
Middle Name:POSSEMATO
Last Name:O'DONNELL
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:SHANLEY
Other - Middle Name:DAWNE
Other - Last Name:POSSEMATO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS
Mailing Address - Street 1:283 S BUTLER RD
Mailing Address - Street 2:
Mailing Address - City:MT GRETNA
Mailing Address - State:PA
Mailing Address - Zip Code:17064-0550
Mailing Address - Country:US
Mailing Address - Phone:800-932-0359
Mailing Address - Fax:
Practice Address - Street 1:283 S BUTLER RD
Practice Address - Street 2:
Practice Address - City:MT GRETNA
Practice Address - State:PA
Practice Address - Zip Code:17064-0550
Practice Address - Country:US
Practice Address - Phone:800-932-0359
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-29
Last Update Date:2015-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health