Basic Information
| Provider Information | |||||||||
| NPI: | 1811493141 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BROWNE | ||||||||
| FirstName: | SHANNON | ||||||||
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| Credential: | OT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7 CARNEGIE PLZ | ||||||||
| Address2: | |||||||||
| City: | CHERRY HILL | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 080031000 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8774073422 | ||||||||
| FaxNumber: | 8774074329 | ||||||||
| Practice Location | |||||||||
| Address1: | 800 N LAKE DR | ||||||||
| Address2: | |||||||||
| City: | LEXINGTON | ||||||||
| State: | SC | ||||||||
| PostalCode: | 290722903 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8774073422 | ||||||||
| FaxNumber: | 8774074329 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/04/2018 | ||||||||
| LastUpdateDate: | 04/04/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225X00000X | 3202 | SC | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist |
No ID Information.