Doctor Name: | MRS. SHANNON CASON MCCOY |
NPI Number: | 1992928279 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.A., CCC-SLP |
License Number: | SA 6607 |
Business Practice Address: | 603 E Call St Starke, FL - 320913405 |
Business Phone Number: | 9049648900 |
Business Fax Number: | 9049645309 |
Mailing Address: | 129 Sw Depot Way, FORT WHITE |
State: | FL |
Postal Code: | 320383442 |
Phone Number: | 3864974020 |
Fax Number: | 9049645309 |
NPI Enumeration Date: | 04/11/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | SA 6607 |
Healthcare Provider Taxonomy: (Secondary) | Y |
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 |