Provider Demographics
NPI:1104102011
Name:ORR, SHANNON ROBINSON (SLP)
Entity type:Individual
Prefix:MRS
First Name:SHANNON
Middle Name:ROBINSON
Last Name:ORR
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37 SHADOW LN
Mailing Address - Street 2:
Mailing Address - City:WHISPERING PINES
Mailing Address - State:NC
Mailing Address - Zip Code:28327-9359
Mailing Address - Country:US
Mailing Address - Phone:803-467-3642
Mailing Address - Fax:
Practice Address - Street 1:37 SHADOW LN
Practice Address - Street 2:
Practice Address - City:WHISPERING PINES
Practice Address - State:NC
Practice Address - Zip Code:28327-9359
Practice Address - Country:US
Practice Address - Phone:803-467-3642
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-25
Last Update Date:2014-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC11202235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist