Provider Demographics
NPI:1730075177
Name:LOISEAU, SHANNON (OTD)
Entity type:Individual
Prefix:
First Name:SHANNON
Middle Name:
Last Name:LOISEAU
Suffix:
Gender:F
Credentials:OTD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:693 HANON DR
Mailing Address - Street 2:
Mailing Address - City:WILLISTON
Mailing Address - State:VT
Mailing Address - Zip Code:05495-8986
Mailing Address - Country:US
Mailing Address - Phone:802-881-9726
Mailing Address - Fax:
Practice Address - Street 1:6355 WALKER LN STE 100
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22310-3238
Practice Address - Country:US
Practice Address - Phone:703-797-6800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-13
Last Update Date:2025-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand