Individual
SHANNON LEE TREDWAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
3801 OLD BRUCEVILLE RD, VINCENNES, IN 47591-3889
(812) 886-4677
Mailing address
14930 WHEATCROFT LN, EVANSVILLE, IN 47725-8748
(217) 649-2874
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
146010018
IL
235Z00000X
Speech-Language Pathologist
Primary
22004983A
IN
Other
Enumeration date
03/19/2014
Last updated
03/19/2014
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