Individual
SHANE JAMES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.S. CCC-SLP
Contact information
Practice address
425 MEDICAL DR STE 122, BOUNTIFUL, UT 84010
(801) 719-0754
(385) 275-6764
Mailing address
425 MEDICAL DR STE 122, BOUNTIFUL, UT 84010-4956
(801) 719-0754
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
284413-4102-20150323
UT
Other
Enumeration date
04/15/2015
Last updated
05/22/2018
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