Individual
SHAYANNE ROTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS CCC-SLP
Contact information
Practice address
3900 E 900 N, OSSIAN, IN 46777-9253
(260) 241-7887
Mailing address
3900 E 900 N, OSSIAN, IN 46777-9253
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
9531
MN
235Z00000X
Speech-Language Pathologist
9592
MA
235Z00000X
Speech-Language Pathologist
SA12974
FL
Other
Enumeration date
06/22/2016
Last updated
06/22/2016
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