Provider Demographics
NPI:1689643181
Name:SHAKIR, NAILAH (MA, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:NAILAH
Middle Name:
Last Name:SHAKIR
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:312 CURVEWOOD RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29229-7127
Mailing Address - Country:US
Mailing Address - Phone:803-419-0047
Mailing Address - Fax:803-419-0340
Practice Address - Street 1:312 CURVEWOOD RD
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29229-7127
Practice Address - Country:US
Practice Address - Phone:803-419-0047
Practice Address - Fax:803-419-0340
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3593235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist