Provider Demographics
NPI:1942873393
Name:SHUNK, ALLISON ALVENA (MS, OTRL)
Entity type:Individual
Prefix:MISS
First Name:ALLISON
Middle Name:ALVENA
Last Name:SHUNK
Suffix:
Gender:F
Credentials:MS, OTRL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2548 FESSENDEN ST APT 104
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MI
Mailing Address - Zip Code:49201-3140
Mailing Address - Country:US
Mailing Address - Phone:989-808-3891
Mailing Address - Fax:
Practice Address - Street 1:100 E MICHIGAN AVE
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MI
Practice Address - Zip Code:49201-1498
Practice Address - Country:US
Practice Address - Phone:517-205-7252
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-22
Last Update Date:2025-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5201011253225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist