Provider Demographics
NPI:1891208880
Name:SHANK, CAYLEIGH (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:CAYLEIGH
Middle Name:
Last Name:SHANK
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3330 DARTMOUTH DR
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45211-6648
Mailing Address - Country:US
Mailing Address - Phone:513-236-7622
Mailing Address - Fax:
Practice Address - Street 1:56 COOPER AVE
Practice Address - Street 2:
Practice Address - City:CLEVES
Practice Address - State:OH
Practice Address - Zip Code:45002-1002
Practice Address - Country:US
Practice Address - Phone:513-467-3500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-13
Last Update Date:2023-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSP.13251235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist