Individual
MR. SHAWN GILLENS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M. A. CCC-SLP
Contact information
Practice address
1401 FARRINGTON WAY APT B, COLUMBIA, SC 29210-6076
(803) 546-6227
Mailing address
PO BOX 21246, COLUMBIA, SC 29221-1246
(803) 546-6227
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
8193
SC
Other
Enumeration date
05/10/2024
Last updated
05/10/2024
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