Individual
SHANNON HENTRUP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
303 N HURSTBOURNE PKWY STE 200, LOUISVILLE, KY 40222-5158
(502) 412-5847
Mailing address
621 E 20TH ST, FERDINAND, IN 47532-9220
(812) 639-7745
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
46004164A
IN
Other
Enumeration date
08/15/2022
Last updated
08/15/2022
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