Provider Demographics
NPI:1386956597
Name:CREWS, SHAYE FABREE (SLP)
Entity type:Individual
Prefix:
First Name:SHAYE
Middle Name:FABREE
Last Name:CREWS
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 1:1611 LAMAR AVENUE
Mailing Address - Street 2:
Mailing Address - City:WAYCROSS
Mailing Address - State:GA
Mailing Address - Zip Code:31503
Mailing Address - Country:US
Mailing Address - Phone:912-227-7301
Mailing Address - Fax:
Practice Address - Street 1:1611 LAMAR AVE
Practice Address - Street 2:
Practice Address - City:WAYCROSS
Practice Address - State:GA
Practice Address - Zip Code:31503-5835
Practice Address - Country:US
Practice Address - Phone:912-227-7301
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-06
Last Update Date:2017-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPCET001525235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist