Provider Demographics
NPI:1962790030
Name:FRANKLIN, SHANNON (OTRL)
Entity type:Individual
Prefix:
First Name:SHANNON
Middle Name:
Last Name:FRANKLIN
Suffix:
Gender:F
Credentials:OTRL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:147 REYBURN RD
Mailing Address - Street 2:
Mailing Address - City:SHICKSHINNY
Mailing Address - State:PA
Mailing Address - Zip Code:18655-4605
Mailing Address - Country:US
Mailing Address - Phone:717-404-3794
Mailing Address - Fax:
Practice Address - Street 1:500 FOWLER AVE STE 104
Practice Address - Street 2:
Practice Address - City:BERWICK
Practice Address - State:PA
Practice Address - Zip Code:18603-3326
Practice Address - Country:US
Practice Address - Phone:570-759-2000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-11
Last Update Date:2022-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOC011118225XP0019X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0019XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPhysical Rehabilitation