Provider Demographics
NPI:1518486448
Name:GLATT, SHAYNA (MS CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:SHAYNA
Middle Name:
Last Name:GLATT
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 1:14749 77TH AVE
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11367-3123
Mailing Address - Country:US
Mailing Address - Phone:786-380-7414
Mailing Address - Fax:
Practice Address - Street 1:2480 E TOMPKINS AVE STE 222
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89121-7625
Practice Address - Country:US
Practice Address - Phone:702-262-0037
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-12
Last Update Date:2021-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVSP-3151235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist