Provider Demographics
NPI:1306419619
Name:TAN, SHUEN HWEE ROWENA (MED, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:SHUEN HWEE
Middle Name:ROWENA
Last Name:TAN
Suffix:
Gender:F
Credentials:MED, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1912 ASCOT TER NW
Mailing Address - Street 2:
Mailing Address - City:ACWORTH
Mailing Address - State:GA
Mailing Address - Zip Code:30102-7982
Mailing Address - Country:US
Mailing Address - Phone:678-386-8165
Mailing Address - Fax:
Practice Address - Street 1:1301 SHILOH RD NW STE 1630
Practice Address - Street 2:
Practice Address - City:KENNESAW
Practice Address - State:GA
Practice Address - Zip Code:30144-7168
Practice Address - Country:US
Practice Address - Phone:770-558-5491
Practice Address - Fax:470-407-6980
Is Sole Proprietor?:No
Enumeration Date:2021-07-23
Last Update Date:2021-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GASLP004980235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist