Provider Demographics
NPI:1114368446
Name:SINGER, SHANNON ASHLEY (SLP-CFY)
Entity Type:Individual
Prefix:
First Name:SHANNON
Middle Name:ASHLEY
Last Name:SINGER
Suffix:
Gender:F
Credentials:SLP-CFY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:906 FAIRWAY DR
Mailing Address - Street 2:
Mailing Address - City:SEARCY
Mailing Address - State:AR
Mailing Address - Zip Code:72143-4582
Mailing Address - Country:US
Mailing Address - Phone:501-278-9324
Mailing Address - Fax:
Practice Address - Street 1:906 FAIRWAY DR
Practice Address - Street 2:
Practice Address - City:SEARCY
Practice Address - State:AR
Practice Address - Zip Code:72143-4582
Practice Address - Country:US
Practice Address - Phone:501-278-9324
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-15
Last Update Date:2013-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARP8695235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR198867721Medicaid