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
Phone: (404) 395-4578
Fax: (404) 920-3396
Website:
Health care specialties
| Specialty | Code | License # | 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1710979281 | NPPES |
| Georgia | MEDICAID | 000891943G | |
| Georgia | MEDICAID | 000891943H | |
| Georgia | MEDICAID | 000891943E |
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