Provider Demographics
NPI:1922317031
Name:AROLA, SHANNON CRADY (MHS)
Entity Type:Individual
Prefix:
First Name:SHANNON
Middle Name:CRADY
Last Name:AROLA
Suffix:
Gender:F
Credentials:MHS
Other - Prefix:
Other - First Name:SHANNON
Other - Middle Name:CRADY
Other - Last Name:AROLA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MHS
Mailing Address - Street 1:5930 SW ARCHER RD
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32608-4702
Mailing Address - Country:US
Mailing Address - Phone:352-332-2629
Mailing Address - Fax:352-283-8650
Practice Address - Street 1:5930 SW ARCHER RD
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32608-4702
Practice Address - Country:US
Practice Address - Phone:352-332-2629
Practice Address - Fax:352-283-8650
Is Sole Proprietor?:No
Enumeration Date:2010-10-07
Last Update Date:2010-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT9780225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics