Provider Demographics
NPI:1255908109
Name:MCINTYRE, SHANNON (MS)
Entity type:Individual
Prefix:
First Name:SHANNON
Middle Name:
Last Name:MCINTYRE
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5444 ERIE STATION LN APT 103
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45227-2590
Mailing Address - Country:US
Mailing Address - Phone:440-742-1724
Mailing Address - Fax:
Practice Address - Street 1:10506A MONTGOMERY RD STE 1078
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:OH
Practice Address - Zip Code:45242-4402
Practice Address - Country:US
Practice Address - Phone:513-865-6137
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-09
Last Update Date:2021-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS