Doctor Name: | MRS. SHANNON PARKER MEDLIN |
NPI Number: | 1639486624 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.S.P. |
License Number: | 4717 |
Business Practice Address: | 1115 Nature Ln Gilbert, SC - 290549754 |
Business Phone Number: | 8032607833 |
Business Fax Number: | |
Mailing Address: | 1115 Nature Ln, GILBERT |
State: | SC |
Postal Code: | 290549754 |
Phone Number: | 8032607833 |
Fax Number: | |
NPI Enumeration Date: | 09/12/2010 |
NPI Last Update Date: | 09/12/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 4717 |
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 |