Provider Demographics
NPI:1144392309
Name:LAWRENCE, SHANNON J
Entity Type:Individual
Prefix:
First Name:SHANNON
Middle Name:J
Last Name:LAWRENCE
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 1:400 LINWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:HOT SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:71913-3749
Mailing Address - Country:US
Mailing Address - Phone:501-623-7421
Mailing Address - Fax:501-620-7847
Practice Address - Street 1:400 LINWOOD AVE
Practice Address - Street 2:
Practice Address - City:HOT SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:71913-3749
Practice Address - Country:US
Practice Address - Phone:501-623-7421
Practice Address - Fax:501-620-7847
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist