| Doctor Name: | MRS. SHANNON RAE HALE |
| NPI Number: | 1326003153 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MED, CCC-SLP |
| License Number: | SP1770 |
| Business Practice Address: | 5 Cr 6575 Ruth N. Bond Elementary School Kirtland, NM - 87417 |
| Business Phone Number: | 5055985178 |
| Business Fax Number: | 5055989507 |
| Mailing Address: | 583 Lr 6100, Central Consolidated School District #22 KIRTLAND |
| State: | NM |
| Postal Code: | 87417 |
| Phone Number: | 5055985834 |
| Fax Number: | 5055986626 |
| NPI Enumeration Date: | 04/17/2006 |
| NPI Last Update Date: | 08/05/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | SP1770 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AZ |
| Taxonomy Type: | Speech, Language and Hearing Service Providers |
| Taxonomy Classification: | Speech-Language Pathologist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A speech pathologist is a person qualified by a master |