Individual
MISS SHANITA D SHAW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.A CCC-SLP
Contact information
Practice address
2495 FAIRWAY DR, ORANGEBURG, SC 29118-4003
(803) 378-5284
(803) 531-6322
Mailing address
2495 FAIRWAY DR, ORANGEBURG, SC 29118-4003
(803) 378-5284
(803) 531-6322
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
3585
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
SA0712
—
SC
Enumeration date
08/31/2006
Last updated
05/26/2021
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