Tyler, Shannon Marie

Tyler, Shannon Marie is an sole proprietor health care provider with primary practice located at 960 Durham Way , Stockbridge GA 30281-7950. 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. Tyler, Shannon Marie can be contacted via phone (404) 395-4578.

Contact Information

Primary practice address
960 Durham Way Stockbridge GA 30281-7950
Fax: (404) 920-3396
Website:

Health care specialties

SpecialtyCodeLicense #State
Speech, Language and Hearing Service Providers / Speech-Language Pathologist 235Z00000X SLP004924 Georgia

Profile Details

NPI number 1710979281
LBN Legal business name Tyler, Shannon Marie
Credentials MS CCC-SLP
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 19th, 2005
Last updated Jan 15th, 2014 - 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 1710979281 NPPES
Georgia MEDICAID 000891943G
Georgia MEDICAID 000891943H
Georgia MEDICAID 000891943E

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