Provider Demographics
NPI:1861513095
Name:SLAGEL, SHAWN ELIZABETH (MS OTR)
Entity type:Individual
Prefix:MS
First Name:SHAWN
Middle Name:ELIZABETH
Last Name:SLAGEL
Suffix:
Gender:F
Credentials:MS OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2788 N. BARNHILL PL
Mailing Address - Street 2:
Mailing Address - City:XENIA
Mailing Address - State:OH
Mailing Address - Zip Code:45385-4538
Mailing Address - Country:US
Mailing Address - Phone:937-581-1348
Mailing Address - Fax:
Practice Address - Street 1:711 DAYTON XENIA RD
Practice Address - Street 2:GREENWOOD MANOR
Practice Address - City:XENIA
Practice Address - State:OH
Practice Address - Zip Code:45385
Practice Address - Country:US
Practice Address - Phone:937-562-7550
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH004466225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist