Provider Demographics
NPI:1053995126
Name:FIOLA, SHANNON MARIE (PTA)
Entity type:Individual
Prefix:
First Name:SHANNON
Middle Name:MARIE
Last Name:FIOLA
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:93 EXETER RD APT 1
Mailing Address - Street 2:
Mailing Address - City:HAMPTON
Mailing Address - State:NH
Mailing Address - Zip Code:03842-1956
Mailing Address - Country:US
Mailing Address - Phone:603-918-1785
Mailing Address - Fax:
Practice Address - Street 1:93 EXETER RD APT 1
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:NH
Practice Address - Zip Code:03842-1956
Practice Address - Country:US
Practice Address - Phone:603-918-1785
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-05
Last Update Date:2021-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH1226225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant