Provider Demographics
NPI:1013627157
Name:GEIL, SHANDA (OTR/L)
Entity Type:Individual
Prefix:
First Name:SHANDA
Middle Name:
Last Name:GEIL
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:SHANDA
Other - Middle Name:
Other - Last Name:EDSALL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1091 MUNROE FALLS KENT RD
Mailing Address - Street 2:
Mailing Address - City:KENT
Mailing Address - State:OH
Mailing Address - Zip Code:44240-3353
Mailing Address - Country:US
Mailing Address - Phone:616-717-1362
Mailing Address - Fax:
Practice Address - Street 1:1500 CANTON RD
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44312-4089
Practice Address - Country:US
Practice Address - Phone:330-784-1271
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-30
Last Update Date:2022-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOT011886225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist