Provider Demographics
NPI:1891979365
Name:RESENDES, SHAWNA MARIE (MS CCC-SLP)
Entity Type:Individual
Prefix:MISS
First Name:SHAWNA
Middle Name:MARIE
Last Name:RESENDES
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 1:114 BRANDEIS CIR
Mailing Address - Street 2:
Mailing Address - City:HALIFAX
Mailing Address - State:MA
Mailing Address - Zip Code:02338-1035
Mailing Address - Country:US
Mailing Address - Phone:508-245-7763
Mailing Address - Fax:
Practice Address - Street 1:114 BRANDEIS CIR
Practice Address - Street 2:
Practice Address - City:HALIFAX
Practice Address - State:MA
Practice Address - Zip Code:02338-1035
Practice Address - Country:US
Practice Address - Phone:508-245-7763
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-19
Last Update Date:2022-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA7208235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist