Provider Demographics
NPI:1114265808
Name:ROWE, SHANNA LEE (MA, CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:SHANNA
Middle Name:LEE
Last Name:ROWE
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:639 VISTA VIEW LN
Mailing Address - Street 2:
Mailing Address - City:LAKE WALES
Mailing Address - State:FL
Mailing Address - Zip Code:33853-4261
Mailing Address - Country:US
Mailing Address - Phone:407-687-9154
Mailing Address - Fax:
Practice Address - Street 1:639 VISTA VIEW LN
Practice Address - Street 2:
Practice Address - City:LAKE WALES
Practice Address - State:FL
Practice Address - Zip Code:33853-4261
Practice Address - Country:US
Practice Address - Phone:407-687-9154
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-30
Last Update Date:2024-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist