Provider Demographics
NPI:1457832073
Name:CADENA, SHANNA S (COTA)
Entity Type:Individual
Prefix:
First Name:SHANNA
Middle Name:S
Last Name:CADENA
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:419 S ELM ST
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76201-6085
Mailing Address - Country:US
Mailing Address - Phone:361-348-3553
Mailing Address - Fax:361-348-3596
Practice Address - Street 1:419 S ELM ST
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76201-6085
Practice Address - Country:US
Practice Address - Phone:361-348-3553
Practice Address - Fax:361-348-3596
Is Sole Proprietor?:No
Enumeration Date:2018-08-22
Last Update Date:2018-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX212278225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist