Provider Demographics
NPI:1497970149
Name:ROSENMAN, SHANNON (OTR-L)
Entity Type:Individual
Prefix:MS
First Name:SHANNON
Middle Name:
Last Name:ROSENMAN
Suffix:
Gender:F
Credentials:OTR-L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:211 LOCH ALSH DR
Mailing Address - Street 2:
Mailing Address - City:CHALFONT
Mailing Address - State:PA
Mailing Address - Zip Code:18914-3914
Mailing Address - Country:US
Mailing Address - Phone:610-662-8411
Mailing Address - Fax:
Practice Address - Street 1:211 LOCH ALSH DR
Practice Address - Street 2:
Practice Address - City:CHALFONT
Practice Address - State:PA
Practice Address - Zip Code:18914-3914
Practice Address - Country:US
Practice Address - Phone:610-662-8411
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC003050L225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist