Provider Demographics
NPI:1952026502
Name:ROBLES, SHANEL
Entity Type:Individual
Prefix:
First Name:SHANEL
Middle Name:
Last Name:ROBLES
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 1:6973 OVERSEAS HWY APT 39
Mailing Address - Street 2:
Mailing Address - City:MARATHON
Mailing Address - State:FL
Mailing Address - Zip Code:33050-3560
Mailing Address - Country:US
Mailing Address - Phone:518-379-6908
Mailing Address - Fax:
Practice Address - Street 1:6973 OVERSEAS HWY APT 39
Practice Address - Street 2:
Practice Address - City:MARATHON
Practice Address - State:FL
Practice Address - Zip Code:33050-3560
Practice Address - Country:US
Practice Address - Phone:518-379-6908
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-06
Last Update Date:2022-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225CA2500XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation CounselorAssistive Technology Supplier