Provider Demographics
NPI:1518348184
Name:RHONE, SHANTAE (MS,OTR/L)
Entity Type:Individual
Prefix:
First Name:SHANTAE
Middle Name:
Last Name:RHONE
Suffix:
Gender:F
Credentials:MS,OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:542 E 87TH ST
Mailing Address - Street 2:APT 3
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11236-3229
Mailing Address - Country:US
Mailing Address - Phone:718-506-6816
Mailing Address - Fax:
Practice Address - Street 1:542 E 87TH ST
Practice Address - Street 2:APT 3
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11236-3229
Practice Address - Country:US
Practice Address - Phone:718-506-6816
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-09
Last Update Date:2016-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY019706225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist