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Organization
SHANNON TAYLOR, SPEECH LANGUAGE PATHOLOGIST, INC.
Active
Organization
SHANNON TAYLOR, SPEECH LANGUAGE PATHOLOGIST, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SHANNON E TAYLOR (OWNER)
(772) 528-1842
Entity
Organization
Contact information
Practice address
2456 SW INDEPENDENCE RD, PORT ST LUCIE, FL 34953-2415
(772) 528-1842
(888) 899-5320
Mailing address
2456 SW INDEPENDENCE RD, PORT ST LUCIE, FL 34953-2415
(772) 528-1842
(888) 899-5320
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SA7003
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
892221700
—
FL
Enumeration date
06/02/2014
Last updated
06/02/2014
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