Provider Demographics
NPI:1982921250
Name:MCLAUGHLIN, SHANNON RAE (OTR)
Entity type:Individual
Prefix:MISS
First Name:SHANNON
Middle Name:RAE
Last Name:MCLAUGHLIN
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5109 N 16TH ST
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78504-3546
Mailing Address - Country:US
Mailing Address - Phone:956-655-5744
Mailing Address - Fax:
Practice Address - Street 1:216 E INTERSTATE 2 STE K
Practice Address - Street 2:
Practice Address - City:PHARR
Practice Address - State:TX
Practice Address - Zip Code:78577-6505
Practice Address - Country:US
Practice Address - Phone:956-588-4060
Practice Address - Fax:956-588-4050
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-27
Last Update Date:2018-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX111535225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist