Provider Demographics
NPI:1831304773
Name:BEYER, SHAUNA J (SLP)
Entity type:Individual
Prefix:
First Name:SHAUNA
Middle Name:J
Last Name:BEYER
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:SHAUNA
Other - Middle Name:J
Other - Last Name:RUZICH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:SLP
Mailing Address - Street 1:622 BELLEVUE DRIVE
Mailing Address - Street 2:
Mailing Address - City:PADUCAH
Mailing Address - State:KY
Mailing Address - Zip Code:42001-4614
Mailing Address - Country:US
Mailing Address - Phone:815-319-8595
Mailing Address - Fax:
Practice Address - Street 1:622 BELLEVUE DRIVE
Practice Address - Street 2:
Practice Address - City:PADUCAH
Practice Address - State:KY
Practice Address - Zip Code:42001-4614
Practice Address - Country:US
Practice Address - Phone:815-931-8595
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-14
Last Update Date:2025-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
222Q00000X
IL146006731235Z00000X
KY279430235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
No222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist