Provider Demographics
NPI:1811887441
Name:JOSEFOSKI, SHANNON MASHALE
Entity type:Individual
Prefix:
First Name:SHANNON
Middle Name:MASHALE
Last Name:JOSEFOSKI
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 1:1324 STEWART ST
Mailing Address - Street 2:
Mailing Address - City:NATRONA HEIGHTS
Mailing Address - State:PA
Mailing Address - Zip Code:15065-1739
Mailing Address - Country:US
Mailing Address - Phone:724-980-3814
Mailing Address - Fax:
Practice Address - Street 1:1324 STEWART ST
Practice Address - Street 2:
Practice Address - City:NATRONA HEIGHTS
Practice Address - State:PA
Practice Address - Zip Code:15065-1739
Practice Address - Country:US
Practice Address - Phone:724-980-3814
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-07
Last Update Date:2025-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician