Provider Demographics
NPI:1821244120
Name:WHITE, SHAMIA LOUISE (MS CCC-SLP)
Entity Type:Individual
Prefix:
First Name:SHAMIA
Middle Name:LOUISE
Last Name:WHITE
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 1:7 HUNTINGTON BEND DR
Mailing Address - Street 2:
Mailing Address - City:MANVEL
Mailing Address - State:TX
Mailing Address - Zip Code:77578-3280
Mailing Address - Country:US
Mailing Address - Phone:832-725-1970
Mailing Address - Fax:
Practice Address - Street 1:2525 CENTERVILLE RD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75228-2634
Practice Address - Country:US
Practice Address - Phone:214-324-3328
Practice Address - Fax:214-324-3328
Is Sole Proprietor?:No
Enumeration Date:2008-08-18
Last Update Date:2019-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX103491235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist