Provider Demographics
NPI:1417484031
Name:HENSLEE, SHANIELLE (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:SHANIELLE
Middle Name:
Last Name:HENSLEE
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 1:630 STONEGLEN DR STE B
Mailing Address - Street 2:
Mailing Address - City:KELLER
Mailing Address - State:TX
Mailing Address - Zip Code:76248-3626
Mailing Address - Country:US
Mailing Address - Phone:817-734-6515
Mailing Address - Fax:817-717-8584
Practice Address - Street 1:630 STONEGLEN DR STE B
Practice Address - Street 2:
Practice Address - City:KELLER
Practice Address - State:TX
Practice Address - Zip Code:76248-3626
Practice Address - Country:US
Practice Address - Phone:817-734-6515
Practice Address - Fax:817-717-8584
Is Sole Proprietor?:No
Enumeration Date:2017-05-13
Last Update Date:2021-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
235Z00000X
TX115861235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist