Provider Demographics
NPI:1215290879
Name:SHOEMAKER, KATLYN MARIE
Entity type:Individual
Prefix:MISS
First Name:KATLYN
Middle Name:MARIE
Last Name:SHOEMAKER
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 1:1665 HEMLOCK CIRCLE
Mailing Address - Street 2:
Mailing Address - City:DOWNINGTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19335
Mailing Address - Country:US
Mailing Address - Phone:610-235-7808
Mailing Address - Fax:
Practice Address - Street 1:800 WEST MINOR STREET
Practice Address - Street 2:
Practice Address - City:WEST CHESTER
Practice Address - State:PA
Practice Address - Zip Code:19383
Practice Address - Country:US
Practice Address - Phone:610-696-3120
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-19
Last Update Date:2012-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant