Shannon M Fahey
Individual provider Active NPI Day Training/Habilitation Specialist · Egg Harbor, WI
NPI 1497592075 · NPPES record last updated Jul 11, 2024
Key facts
- NPI
- 1497592075
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Day Training/Habilitation Specialist 373H00000X
- Practice address
- 4976 Plum Bottom Rd
Egg Harbor, WI 54209-9147 - Phone
- (920) 418-3330
- NPI assigned
- Jul 11, 2024
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Day Training/Habilitation Specialist | 373H00000X | Yes |
Addresses
Primary practice location
4976 Plum Bottom Rd
Egg Harbor, WI 54209-9147
Mailing address
4976 Plum Bottom Rd
Egg Harbor, WI 54209-9147
Phone (920) 418-3330
Other names
- Shannon M Wautier
Other providers in Egg Harbor, WI
- Bay Psychiatry of Wisconsin LLC
- Corinne Leah Bosse
- Sandra Lynne Chlubna
- Anna Kate Giblin
- Margaret Giblin
- Integrated Health Services of Door County Inc.
- Kari Lynn Mahlik
- Eileen O'Malley
All providers in Egg Harbor, WI · Day Training/Habilitation Specialist in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 11, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.