Provider Demographics
NPI:1376618868
Name:BRUMFIELD, SHANNON MAUREEN (PHD, CCC-SLP)
Entity Type:Individual
Prefix:DR
First Name:SHANNON
Middle Name:MAUREEN
Last Name:BRUMFIELD
Suffix:
Gender:F
Credentials:PHD, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3201 NW 58TH BLVD
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32606-6938
Mailing Address - Country:US
Mailing Address - Phone:352-375-2913
Mailing Address - Fax:
Practice Address - Street 1:435 DAUER HALL, BUCKMAN DRIVE
Practice Address - Street 2:U OF FL SPEECH AND HEARING CLINIC
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32611-7420
Practice Address - Country:US
Practice Address - Phone:352-392-2041
Practice Address - Fax:352-846-2189
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA 4503235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist