Provider Demographics
NPI:1942455118
Name:ANTHONY, SHAWN MARIE
Entity Type:Individual
Prefix:
First Name:SHAWN
Middle Name:MARIE
Last Name:ANTHONY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1707 BROOKSTONE DR
Mailing Address - Street 2:
Mailing Address - City:ALBURTIS
Mailing Address - State:PA
Mailing Address - Zip Code:18011-2716
Mailing Address - Country:US
Mailing Address - Phone:610-530-7903
Mailing Address - Fax:
Practice Address - Street 1:2029 WESTGATE DR
Practice Address - Street 2:
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18017-7412
Practice Address - Country:US
Practice Address - Phone:610-861-0100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-12-01
Last Update Date:2008-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOP001079L224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant