Provider Demographics
NPI:1962362236
Name:OZENE, SHANNON COLLETTE (LMT)
Entity type:Individual
Prefix:MS
First Name:SHANNON
Middle Name:COLLETTE
Last Name:OZENE
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 MCDONALD ST APT 15K
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70506-5322
Mailing Address - Country:US
Mailing Address - Phone:337-296-9679
Mailing Address - Fax:
Practice Address - Street 1:100 MCDONALD ST APT 15K
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70506-5322
Practice Address - Country:US
Practice Address - Phone:337-296-9679
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-11-17
Last Update Date:2025-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LALA9741225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist