Provider Demographics
NPI:1336499391
Name:FLANNERY, SHANNON (SLP)
Entity Type:Individual
Prefix:
First Name:SHANNON
Middle Name:
Last Name:FLANNERY
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:436 HOUSTON OAKS DR
Mailing Address - Street 2:
Mailing Address - City:PARIS
Mailing Address - State:KY
Mailing Address - Zip Code:40361-2704
Mailing Address - Country:US
Mailing Address - Phone:606-584-1169
Mailing Address - Fax:800-584-1465
Practice Address - Street 1:436 HOUSTON OAKS DR
Practice Address - Street 2:
Practice Address - City:PARIS
Practice Address - State:KY
Practice Address - Zip Code:40361-2704
Practice Address - Country:US
Practice Address - Phone:606-584-1169
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-17
Last Update Date:2020-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist