Provider Demographics
NPI:1508910878
Name:HOULE, SHAUNNA MARIE (DPT)
Entity Type:Individual
Prefix:MRS
First Name:SHAUNNA
Middle Name:MARIE
Last Name:HOULE
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1066 HOLMES RD
Mailing Address - Street 2:
Mailing Address - City:PITTSFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01201-7146
Mailing Address - Country:US
Mailing Address - Phone:802-359-3106
Mailing Address - Fax:
Practice Address - Street 1:103 S MAIN ST
Practice Address - Street 2:
Practice Address - City:WEST LEBANON
Practice Address - State:NH
Practice Address - Zip Code:03784-1618
Practice Address - Country:US
Practice Address - Phone:603-298-5595
Practice Address - Fax:603-298-5205
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-23
Last Update Date:2018-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH3201225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist