Provider Demographics
NPI:1598940447
Name:SHAY, LYNNE MASON (MA)
Entity Type:Individual
Prefix:
First Name:LYNNE
Middle Name:MASON
Last Name:SHAY
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5602 CORTEZ RD W
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34210-2819
Mailing Address - Country:US
Mailing Address - Phone:941-761-3044
Mailing Address - Fax:941-761-8554
Practice Address - Street 1:5602 CORTEZ RD W
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34210-2819
Practice Address - Country:US
Practice Address - Phone:941-761-3044
Practice Address - Fax:941-761-8554
Is Sole Proprietor?:No
Enumeration Date:2008-01-09
Last Update Date:2008-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAY 1474231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist