Provider Demographics
NPI:1235753021
Name:REED, SHANE JUSTIN (CF-SLP)
Entity Type:Individual
Prefix:
First Name:SHANE
Middle Name:JUSTIN
Last Name:REED
Suffix:
Gender:M
Credentials:CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6907 SHAWNEE MISSION PKWY
Mailing Address - Street 2:207
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66202
Mailing Address - Country:US
Mailing Address - Phone:888-913-1910
Mailing Address - Fax:877-913-1174
Practice Address - Street 1:6907 SHAWNEE MISSION PKWY
Practice Address - Street 2:207
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66202
Practice Address - Country:US
Practice Address - Phone:888-913-1910
Practice Address - Fax:877-913-1174
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-08
Last Update Date:2020-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty