Provider Demographics
NPI:1588930556
Name:MCFARLAND, SHANNON SMITH (CCC-SLP)
Entity type:Individual
Prefix:MS
First Name:SHANNON
Middle Name:SMITH
Last Name:MCFARLAND
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:606 GORDON ST
Mailing Address - Street 2:
Mailing Address - City:KERNERSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27284-2225
Mailing Address - Country:US
Mailing Address - Phone:336-749-7554
Mailing Address - Fax:
Practice Address - Street 1:606 GORDON ST
Practice Address - Street 2:
Practice Address - City:KERNERSVILLE
Practice Address - State:NC
Practice Address - Zip Code:27284-2225
Practice Address - Country:US
Practice Address - Phone:336-749-7554
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-23
Last Update Date:2012-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC6725235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist