# SHINE SPEECH LANGUAGE PATHOLOGY, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1407594054
- **Authorized official:** LAUREN BEVAN MS, CCC-SLP (SPEECH-LANGUAGE PATHOLOGIST)
- **Authorized official phone:** (717) 343-4073

## Contact information

- **Practice address:** 2450 FEDERAL ST APT 2, PHILADELPHIA, PA 19146-2432
- **Practice address phone:** (717) 343-4073
- **Mailing address:** 2450 FEDERAL ST APT 2, PHILADELPHIA, PA 19146-2432
- **Mailing address phone:** (717) 343-4073

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QH0700X | Hearing and Speech Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 05/24/2022
- **Last updated:** 05/24/2022