Provider Demographics
NPI:1891062790
Name:SYNAN, SHANNON MARIA (MS CCC-SLP)
Entity Type:Individual
Prefix:
First Name:SHANNON
Middle Name:MARIA
Last Name:SYNAN
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 1:316 DONOHOE RD
Mailing Address - Street 2:
Mailing Address - City:GREENSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15601-6988
Mailing Address - Country:US
Mailing Address - Phone:412-613-5141
Mailing Address - Fax:
Practice Address - Street 1:316 DONOHOE RD
Practice Address - Street 2:
Practice Address - City:GREENSBURG
Practice Address - State:PA
Practice Address - Zip Code:15601-6988
Practice Address - Country:US
Practice Address - Phone:412-613-5141
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-11-19
Last Update Date:2011-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL010461235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist