Doctor Name: | MISS SHANNON MITCHELL DUKES |
NPI Number: | 1508129180 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | SLP |
License Number: | 5075 |
Business Practice Address: | 521 Caro Lane Chapin, SC - 290367951 |
Business Phone Number: | 8648332550 |
Business Fax Number: | |
Mailing Address: | 521 Caro Ln, CHAPIN |
State: | SC |
Postal Code: | 290367951 |
Phone Number: | 8036454597 |
Fax Number: | |
NPI Enumeration Date: | 06/19/2012 |
NPI Last Update Date: | 10/29/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 5075 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | SC |
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 |