Doctor Name: | MS. IRENE ROSE SHIELDS |
NPI Number: | 1649560327 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.A., CCC-SLP |
License Number: | SA 10496 |
Business Practice Address: | 700 Lilly Rd Ne Olympia, WA - 985065115 |
Business Phone Number: | 3609237700 |
Business Fax Number: | |
Mailing Address: | 5904 Balustrade Blvd Se, LACEY |
State: | WA |
Postal Code: | 985135075 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 04/14/2011 |
NPI Last Update Date: | 01/26/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | SA 10496 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | FL |
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 |