Provider Demographics
NPI:1790941565
Name:COON, SHAWNA (MS, SLP-CCC)
Entity Type:Individual
Prefix:MRS
First Name:SHAWNA
Middle Name:
Last Name:COON
Suffix:
Gender:F
Credentials:MS, SLP-CCC
Other - Prefix:
Other - First Name:SHAWNA
Other - Middle Name:MARIE
Other - Last Name:KABOT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, SLP-CCC
Mailing Address - Street 1:138 YORKTOWN DR
Mailing Address - Street 2:
Mailing Address - City:WEBSTER
Mailing Address - State:NY
Mailing Address - Zip Code:14580-2243
Mailing Address - Country:US
Mailing Address - Phone:585-944-0638
Mailing Address - Fax:
Practice Address - Street 1:138 YORKTOWN DR
Practice Address - Street 2:
Practice Address - City:WEBSTER
Practice Address - State:NY
Practice Address - Zip Code:14580-2243
Practice Address - Country:US
Practice Address - Phone:585-944-0638
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-31
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY017635235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist