Provider Demographics
NPI:1730638537
Name:MCCOOL, SHANNON (MS CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:SHANNON
Middle Name:
Last Name:MCCOOL
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 1:101 HOSPITAL DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:NC
Mailing Address - Zip Code:28722-6418
Mailing Address - Country:US
Mailing Address - Phone:828-894-0920
Mailing Address - Fax:828-894-0538
Practice Address - Street 1:101 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:NC
Practice Address - Zip Code:28722-6418
Practice Address - Country:US
Practice Address - Phone:828-894-0920
Practice Address - Fax:828-894-0538
Is Sole Proprietor?:No
Enumeration Date:2016-09-22
Last Update Date:2016-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2389235Z00000X
SC2287235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist