Forman, Shannon

Forman, Shannon is an individual health care provider with primary practice located at 100 Blassingame Rd , Greenville SC 29605-3304. She recently has only one registered license in Speech, Language and Hearing Service Providers / Speech-Language Pathologist, which is considered as her primary health care specialty. Forman, Shannon can be contacted via phone (864) 355-3100.

Contact Information

Primary practice address
100 Blassingame Rd Greenville SC 29605-3304
Phone: (864) 355-3100
Fax: (864) 355-9828
Website:
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Health care specialties

SpecialtyCodeLicense #State
Speech, Language and Hearing Service Providers / Speech-Language Pathologist 235Z00000X SA3471 Florida
Speech, Language and Hearing Service Providers / Speech-Language Pathologist 235Z00000X 4188 South Carolina

Profile Details

NPI number 1508933383
LBN Legal business name Forman, Shannon
Credentials 4188
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 29th, 2006
Last updated Jun 4th, 2013 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1508933383 NPPES
Florida MEDICAID 884220500

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