Provider Demographics
NPI:1710302252
Name:FRALEY, SHANA (MS)
Entity Type:Individual
Prefix:
First Name:SHANA
Middle Name:
Last Name:FRALEY
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8600 PARK MEADOWS DR
Mailing Address - Street 2:SUITE 800
Mailing Address - City:LONE TREE
Mailing Address - State:CO
Mailing Address - Zip Code:80124-2756
Mailing Address - Country:US
Mailing Address - Phone:303-946-7150
Mailing Address - Fax:
Practice Address - Street 1:8600 PARK MEADOWS DR
Practice Address - Street 2:SUITE 800
Practice Address - City:LONE TREE
Practice Address - State:CO
Practice Address - Zip Code:80124-2756
Practice Address - Country:US
Practice Address - Phone:303-985-1133
Practice Address - Fax:720-962-0678
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-20
Last Update Date:2014-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO47420235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist