Provider Demographics
NPI:1649744368
Name:HOVEY, SHAUNA (LMT)
Entity Type:Individual
Prefix:
First Name:SHAUNA
Middle Name:
Last Name:HOVEY
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33591 479TH AVE
Mailing Address - Street 2:
Mailing Address - City:JEFFERSON
Mailing Address - State:SD
Mailing Address - Zip Code:57038-6870
Mailing Address - Country:US
Mailing Address - Phone:712-389-4879
Mailing Address - Fax:
Practice Address - Street 1:4016 MORNINGSIDE AVE STE C
Practice Address - Street 2:
Practice Address - City:SIOUX CITY
Practice Address - State:IA
Practice Address - Zip Code:51106-2459
Practice Address - Country:US
Practice Address - Phone:712-258-9045
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-15
Last Update Date:2019-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA074771225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist