Provider Demographics
NPI:1083898340
Name:BROWN-SHAREEF, RENIYA L (SLP)
Entity Type:Individual
Prefix:MRS
First Name:RENIYA
Middle Name:L
Last Name:BROWN-SHAREEF
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 1:3880 171ST PL
Mailing Address - Street 2:
Mailing Address - City:COUNTRY CLUB HILLS
Mailing Address - State:IL
Mailing Address - Zip Code:60478-4685
Mailing Address - Country:US
Mailing Address - Phone:708-960-0161
Mailing Address - Fax:
Practice Address - Street 1:3880 171ST PL
Practice Address - Street 2:
Practice Address - City:COUNTRY CLUB HILLS
Practice Address - State:IL
Practice Address - Zip Code:60478-4685
Practice Address - Country:US
Practice Address - Phone:708-960-0161
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-21
Last Update Date:2007-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist