Provider Demographics
NPI:1639697121
Name:ROTHSCHILD, SHANNA (MFT)
Entity Type:Individual
Prefix:
First Name:SHANNA
Middle Name:
Last Name:ROTHSCHILD
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 ANN BLVD
Mailing Address - Street 2:
Mailing Address - City:SPRING VALLEY
Mailing Address - State:NY
Mailing Address - Zip Code:10977-6316
Mailing Address - Country:US
Mailing Address - Phone:845-422-6948
Mailing Address - Fax:
Practice Address - Street 1:33 PARK AVE
Practice Address - Street 2:
Practice Address - City:AIRMONT
Practice Address - State:NY
Practice Address - Zip Code:10952-4505
Practice Address - Country:US
Practice Address - Phone:845-425-9614
Practice Address - Fax:845-352-0741
Is Sole Proprietor?:No
Enumeration Date:2017-09-05
Last Update Date:2017-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist