Provider Demographics
NPI:1992459804
Name:FROHLOFF, SHAWN (OT)
Entity type:Individual
Prefix:
First Name:SHAWN
Middle Name:
Last Name:FROHLOFF
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2546 RIVER ROAD DR
Mailing Address - Street 2:
Mailing Address - City:WATERLOO
Mailing Address - State:NE
Mailing Address - Zip Code:68069-2064
Mailing Address - Country:US
Mailing Address - Phone:531-444-8945
Mailing Address - Fax:
Practice Address - Street 1:2546 RIVER ROAD DR
Practice Address - Street 2:
Practice Address - City:WATERLOO
Practice Address - State:NE
Practice Address - Zip Code:68069-2064
Practice Address - Country:US
Practice Address - Phone:531-444-8945
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-09
Last Update Date:2022-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE615225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist