Provider Demographics
NPI:1609168731
Name:KNOWLES, SHAWNA
Entity Type:Individual
Prefix:MISS
First Name:SHAWNA
Middle Name:
Last Name:KNOWLES
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 1:2475 W CHEYENNE AVE STE 130
Mailing Address - Street 2:
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89032-4329
Mailing Address - Country:US
Mailing Address - Phone:702-646-7570
Mailing Address - Fax:702-974-1348
Practice Address - Street 1:2475 W CHEYENNE AVE STE 130
Practice Address - Street 2:
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89032-4329
Practice Address - Country:US
Practice Address - Phone:702-646-7570
Practice Address - Fax:702-974-1348
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-08
Last Update Date:2011-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225C00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Counselor