Provider Demographics
NPI:1497224018
Name:BYRAM, SHENA
Entity Type:Individual
Prefix:
First Name:SHENA
Middle Name:
Last Name:BYRAM
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7707 NYESVILLE RD
Mailing Address - Street 2:
Mailing Address - City:CHAMBERSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17202-7326
Mailing Address - Country:US
Mailing Address - Phone:171-781-6742
Mailing Address - Fax:
Practice Address - Street 1:7707 NYESVILLE RD
Practice Address - Street 2:
Practice Address - City:CHAMBERSBURG
Practice Address - State:PA
Practice Address - Zip Code:17202-7326
Practice Address - Country:US
Practice Address - Phone:717-816-7424
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-14
Last Update Date:2018-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDA02609224Z00000X
224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant