Individual
SHANNON M HEPBURN III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSP, CCC-SLP
Contact information
Practice address
257 CEDARHURST DR, CANTON, GA 30115-6445
(404) 918-5392
(678) 493-4710
Mailing address
257 CEDARHURST DR, CANTON, GA 30115-6445
(404) 918-5392
(678) 493-4710
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP004031
GA
Other
Enumeration date
12/15/2006
Last updated
07/08/2007
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