Provider Demographics
NPI:1285035394
Name:MOHLER, SHAWNA (DT)
Entity Type:Individual
Prefix:MRS
First Name:SHAWNA
Middle Name:
Last Name:MOHLER
Suffix:
Gender:F
Credentials:DT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2601 OLD CREAL SPRINGS RD
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:IL
Mailing Address - Zip Code:62959-6203
Mailing Address - Country:US
Mailing Address - Phone:270-906-6008
Mailing Address - Fax:
Practice Address - Street 1:2601 OLD CREAL SPRINGS RD
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:IL
Practice Address - Zip Code:62959-6203
Practice Address - Country:US
Practice Address - Phone:270-906-6008
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-08
Last Update Date:2014-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist