Provider Demographics
NPI:1831653799
Name:SHREWSBURY, MARIA (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:
Last Name:SHREWSBURY
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 1:3905 JOHNS CREEK CT STE 250
Mailing Address - Street 2:
Mailing Address - City:SUWANEE
Mailing Address - State:GA
Mailing Address - Zip Code:30024-1226
Mailing Address - Country:US
Mailing Address - Phone:770-888-5221
Mailing Address - Fax:
Practice Address - Street 1:3905 JOHNS CREEK CT STE 250
Practice Address - Street 2:
Practice Address - City:SUWANEE
Practice Address - State:GA
Practice Address - Zip Code:30024-1226
Practice Address - Country:US
Practice Address - Phone:770-888-5221
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-24
Last Update Date:2019-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GASLP010107235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist