Provider Demographics
NPI:1235882937
Name:SHOEMAKE, SHILO GAGLIANO
Entity Type:Individual
Prefix:MRS
First Name:SHILO
Middle Name:GAGLIANO
Last Name:SHOEMAKE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:SHILO
Other - Middle Name:G
Other - Last Name:MAILHO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:110 HUNT ST
Mailing Address - Street 2:
Mailing Address - City:BELLE CHASSE
Mailing Address - State:LA
Mailing Address - Zip Code:70037-2616
Mailing Address - Country:US
Mailing Address - Phone:504-858-3085
Mailing Address - Fax:
Practice Address - Street 1:110 HUNT ST
Practice Address - Street 2:
Practice Address - City:BELLE CHASSE
Practice Address - State:LA
Practice Address - Zip Code:70037-2616
Practice Address - Country:US
Practice Address - Phone:504-858-3085
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-02
Last Update Date:2022-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist