Basic Information
| Provider Information | |||||||||
| NPI: | 1811588239 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | STONE | ||||||||
| FirstName: | SHAUNEE | ||||||||
| MiddleName: | M | ||||||||
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| Credential: | OTR/L | ||||||||
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| Mailing Information | |||||||||
| Address1: | W180N8508 TOWN HALL RD APT 7 | ||||||||
| Address2: | |||||||||
| City: | MENOMONEE FALLS | ||||||||
| State: | WI | ||||||||
| PostalCode: | 530512585 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2623020324 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1451 CLEVELAND AVE | ||||||||
| Address2: | |||||||||
| City: | WAUKESHA | ||||||||
| State: | WI | ||||||||
| PostalCode: | 531863876 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2625472123 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 01/28/2021 | ||||||||
| LastUpdateDate: | 01/28/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 01/27/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225X00000X | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist |
No ID Information.