Mcdaniel, Shannon K
Mcdaniel, Shannon K is an individual health care provider with primary practice located at 1488 Old Ocilla Rd , Tifton GA 31794-4152. 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. Mcdaniel, Shannon K can be contacted via phone (229) 386-5200.Contact Information
Primary practice address
1488 Old Ocilla Rd
Tifton GA 31794-4152
Phone: (229) 386-5200
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Speech, Language and Hearing Service Providers / Speech-Language Pathologist | 235Z00000X | SLP004230 | Georgia |
Profile Details
| NPI number | 1205989480 |
|---|---|
| LBN Legal business name | Mcdaniel, Shannon K |
| Credentials | MED CCC SLP |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 19th, 2007 |
| Last updated | Jul 9th, 2007 - about 19 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1205989480 | NPPES |
| Georgia | MEDICAID | 00828506A |
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