Provider Demographics
NPI:1417127192
Name:LABADIE, SHAYNA ALISE (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:SHAYNA
Middle Name:ALISE
Last Name:LABADIE
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1850 E MARYLAND AVE UNIT 25
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85016-1428
Mailing Address - Country:US
Mailing Address - Phone:480-258-9139
Mailing Address - Fax:
Practice Address - Street 1:1850 E MARYLAND AVE UNIT 25
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85016-1428
Practice Address - Country:US
Practice Address - Phone:480-258-9139
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-10
Last Update Date:2021-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ35508342355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant