Provider Demographics
NPI:1346785458
Name:MCMAYO, SHEA DANIELLE
Entity Type:Individual
Prefix:
First Name:SHEA
Middle Name:DANIELLE
Last Name:MCMAYO
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 1:11500 SW 64TH ST.
Mailing Address - Street 2:UNIT B
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33173
Mailing Address - Country:US
Mailing Address - Phone:305-338-1588
Mailing Address - Fax:
Practice Address - Street 1:400 UNIVERSITY DR
Practice Address - Street 2:SUITE 501
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-7125
Practice Address - Country:US
Practice Address - Phone:305-854-2471
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-28
Last Update Date:2016-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL27832355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant