Provider Demographics
NPI:1679198253
Name:SHOPE, HANNAH KESSLER (LMT)
Entity Type:Individual
Prefix:
First Name:HANNAH
Middle Name:KESSLER
Last Name:SHOPE
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:HANNAH
Other - Middle Name:KESSLER
Other - Last Name:DIETRICH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:32 DENISE LN
Mailing Address - Street 2:
Mailing Address - City:EPHRATA
Mailing Address - State:PA
Mailing Address - Zip Code:17522-8404
Mailing Address - Country:US
Mailing Address - Phone:717-669-9170
Mailing Address - Fax:
Practice Address - Street 1:918 N READING RD
Practice Address - Street 2:
Practice Address - City:EPHRATA
Practice Address - State:PA
Practice Address - Zip Code:17522-9794
Practice Address - Country:US
Practice Address - Phone:717-335-2338
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-10
Last Update Date:2020-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMSG010936225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist