Provider Demographics
NPI:1962142273
Name:PLOWDEN, SHATAVIA TIARRA
Entity type:Individual
Prefix:
First Name:SHATAVIA
Middle Name:TIARRA
Last Name:PLOWDEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:727 JACKIE LN
Mailing Address - Street 2:
Mailing Address - City:BALDWIN
Mailing Address - State:NY
Mailing Address - Zip Code:11510-4511
Mailing Address - Country:US
Mailing Address - Phone:347-882-4652
Mailing Address - Fax:
Practice Address - Street 1:999 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:WOODMERE
Practice Address - State:NY
Practice Address - Zip Code:11598-1205
Practice Address - Country:US
Practice Address - Phone:516-374-7914
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-01
Last Update Date:2022-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant