Provider Demographics
NPI:1336742220
Name:SHAWLER, DANA M
Entity Type:Individual
Prefix:
First Name:DANA
Middle Name:M
Last Name:SHAWLER
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 1:363 HITHER CREEK LN
Mailing Address - Street 2:
Mailing Address - City:REYNOLDSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:43068-7164
Mailing Address - Country:US
Mailing Address - Phone:937-418-5739
Mailing Address - Fax:
Practice Address - Street 1:363 HITHER CREEK LN
Practice Address - Street 2:
Practice Address - City:REYNOLDSBURG
Practice Address - State:OH
Practice Address - Zip Code:43068-7164
Practice Address - Country:US
Practice Address - Phone:937-418-5739
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-21
Last Update Date:2020-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0057801Medicaid