Provider Demographics
NPI:1558426965
Name:MCKEE, SHAUNA LUANE (MS, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:SHAUNA
Middle Name:LUANE
Last Name:MCKEE
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 1:1923 DOLPHIN BLVD S
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33707-3809
Mailing Address - Country:US
Mailing Address - Phone:727-743-3369
Mailing Address - Fax:727-345-9870
Practice Address - Street 1:1923 DOLPHIN BLVD S
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33707-3809
Practice Address - Country:US
Practice Address - Phone:727-743-3369
Practice Address - Fax:727-345-9870
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-26
Last Update Date:2011-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA 7939235Z00000X
FL001212700222Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
No222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL12106916OtherASHA CERTIFICATION NUMBER
FL888482000Medicaid
FLSA7939OtherSTATE LICENSE NUMBER SLP
FL001212700Medicaid