Individual
SHANNON BLACKSTONE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
33 PERCY ST APT B, CHARLESTON, SC 29403-5957
(803) 212-8971
Mailing address
221 STALLSVILLE RD, SUMMERVILLE, SC 29485-4934
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
4673
SC
Other
Enumeration date
10/18/2010
Last updated
09/29/2025
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