Provider Demographics
NPI:1659848661
Name:ADAMS, SHANNON F (OTR/L)
Entity Type:Individual
Prefix:
First Name:SHANNON
Middle Name:F
Last Name:ADAMS
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:SHANNON
Other - Middle Name:F
Other - Last Name:ALEXANDER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:245 CANTERBURY DR
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19380-1359
Mailing Address - Country:US
Mailing Address - Phone:908-463-4266
Mailing Address - Fax:
Practice Address - Street 1:1380 ENTERPRISE DR STE 200
Practice Address - Street 2:
Practice Address - City:WEST CHESTER
Practice Address - State:PA
Practice Address - Zip Code:19380-5990
Practice Address - Country:US
Practice Address - Phone:610-436-3600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-28
Last Update Date:2023-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC015947225X00000X, 225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist