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NPI Code Detail

MEDICARE: SHANNON HARRER OTR

MEDICARE: SHANNON HARRER OTR
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225X00000XOccupational Therapist46TR00237400NJ

General Provider Information

NPI Number : 1417763715
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHANNON HARRER OTR
Provider Business Mailing Address
First Line : 2 HOLLYWOOD BLVD N STE 8
Second Line :
City : FORKED RIVER
State : NJ
Zip : 08731-4842
Country : US
Telephone Number : 609-200-1118
Fax Number :
Provider Business Practice Location Address
First Line : 2 HOLLYWOOD BLVD N STE 8
Second Line :
City : FORKED RIVER
State : NJ
Zip : 08731-4842
Country : US
Telephone Number : 609-200-1118
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/10/2024
Last Update Date : 12/10/2024

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Directions to “ SHANNON HARRER OTR” Practice Location

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