Provider Demographics
NPI:1962701623
Name:HAYS, SHANNON SHIRLEY (MS - CCC/SLP)
Entity type:Individual
Prefix:MRS
First Name:SHANNON
Middle Name:SHIRLEY
Last Name:HAYS
Suffix:
Gender:F
Credentials:MS - CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:164 W MAIN ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:NEW MARKET
Mailing Address - State:MD
Mailing Address - Zip Code:21774-6279
Mailing Address - Country:US
Mailing Address - Phone:301-606-8278
Mailing Address - Fax:301-865-8178
Practice Address - Street 1:164 W MAIN ST
Practice Address - Street 2:SUITE A
Practice Address - City:NEW MARKET
Practice Address - State:MD
Practice Address - Zip Code:21774-6279
Practice Address - Country:US
Practice Address - Phone:301-606-8278
Practice Address - Fax:301-865-8178
Is Sole Proprietor?:No
Enumeration Date:2011-03-21
Last Update Date:2011-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD06207235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist