Individual
MISS SHANON MARY MCINTYRE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS CCC-SLP
Contact information
Practice address
640 GRAND AVE, GRAND JUNCTION, CO 81501-2738
(561) 262-9124
Mailing address
PO BOX 1993, GRAND JUNCTION, CO 81502-1993
(561) 262-9124
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
12121711
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
40608875
—
CO
05
—
890870200
—
FL
Enumeration date
04/26/2007
Last updated
10/20/2015
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