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NPI Code Detail

MEDICARE: SUZANNE RENEE SHINN LSW

MEDICARE: SUZANNE RENEE SHINN LSW
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
1104100000XSocial WorkerSW009630LPA

General Provider Information

NPI Number : 1881691509
Entity Type Code : Individual
Provider Name (Legal Business Name) : SUZANNE RENEE SHINN LSW
Provider Business Mailing Address
First Line : 200 NORTH 7TH ST
Second Line :
City : LEBANON
State : PA
Zip : 17046
Country : US
Telephone Number : 717-273-1710
Fax Number : 717-273-1416
Provider Business Practice Location Address
First Line : 1733 PENN AVE
Second Line :
City : READING
State : PA
Zip : 19609-2054
Country : US
Telephone Number : 610-670-7270
Fax Number : 610-670-3825
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/07/2005
Last Update Date : 07/08/2007

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Directions to “ SUZANNE RENEE SHINN LSW” Practice Location

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