Provider Demographics
NPI:1609460690
Name:ARMSTRONG, SHANNA (MS, CCC-SLP, L-SLP)
Entity Type:Individual
Prefix:MRS
First Name:SHANNA
Middle Name:
Last Name:ARMSTRONG
Suffix:
Gender:F
Credentials:MS, CCC-SLP, L-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:42221 CONIFER RD
Mailing Address - Street 2:
Mailing Address - City:GONZALES
Mailing Address - State:LA
Mailing Address - Zip Code:70737-7562
Mailing Address - Country:US
Mailing Address - Phone:225-313-8800
Mailing Address - Fax:
Practice Address - Street 1:42221 CONIFER RD
Practice Address - Street 2:
Practice Address - City:GONZALES
Practice Address - State:LA
Practice Address - Zip Code:70737-7562
Practice Address - Country:US
Practice Address - Phone:225-313-8800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-22
Last Update Date:2021-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA12917235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA12917OtherLBESPA