Organization
SHOOTING STAR SPEECH THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHANNON BLACKSTONE MS, CCC-SLP (SPEECH-LANGUAGE PATHOLOGIST, OWNER)
(954) 592-5478
Entity
Organization
Contact information
Practice address
33 PERCY ST APT B, CHARLESTON, SC 29403-5957
(954) 592-5478
Mailing address
33 PERCY ST APT B, CHARLESTON, SC 29403-5957
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Enumeration date
02/27/2024
Last updated
02/27/2024
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