Individual
JODY M SHAHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
7591 TYLERS PLACE BLVD, WEST CHESTER, OH 45069-6308
(513) 755-6600
(513) 755-3762
Mailing address
7591 TYLERS PLACE BLVD, WEST CHESTER, OH 45069-6308
(513) 755-6600
(513) 755-3762
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
20191019-SP
OH
235Z00000X
Speech-Language Pathologist
Primary
SP.13911
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0406425
—
OH
01
—
AB7360731
MEDICARE PIN
OH
Enumeration date
07/12/2019
Last updated
07/23/2020
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