Provider Demographics
NPI:1154991586
Name:BRENNAN, SHAYLEEN ELIZABETH (MED CF-SLP)
Entity type:Individual
Prefix:
First Name:SHAYLEEN
Middle Name:ELIZABETH
Last Name:BRENNAN
Suffix:
Gender:F
Credentials:MED CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:470 N THOMAS ST APT 404
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22203-2491
Mailing Address - Country:US
Mailing Address - Phone:716-462-2816
Mailing Address - Fax:
Practice Address - Street 1:135 MIDDLEBURY RD
Practice Address - Street 2:
Practice Address - City:ORCHARD PARK
Practice Address - State:NY
Practice Address - Zip Code:14127-3585
Practice Address - Country:US
Practice Address - Phone:716-462-2816
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-28
Last Update Date:2021-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2204000723235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist