Provider Demographics
NPI:1184608861
Name:IRELAND, SHAYNA BETH (MS CCC SLP)
Entity type:Individual
Prefix:
First Name:SHAYNA
Middle Name:BETH
Last Name:IRELAND
Suffix:
Gender:F
Credentials:MS CCC SLP
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Other - Credentials:
Mailing Address - Street 1:711 TROY SCHENECTADY RD
Mailing Address - Street 2:209
Mailing Address - City:LATHAM
Mailing Address - State:NY
Mailing Address - Zip Code:12110-2442
Mailing Address - Country:US
Mailing Address - Phone:518-786-1667
Mailing Address - Fax:518-786-1954
Practice Address - Street 1:711 TROY SCHENECTADY RD
Practice Address - Street 2:216
Practice Address - City:LATHAM
Practice Address - State:NY
Practice Address - Zip Code:12110-2442
Practice Address - Country:US
Practice Address - Phone:518-786-1665
Practice Address - Fax:518-785-0056
Is Sole Proprietor?:No
Enumeration Date:2005-12-06
Last Update Date:2008-10-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA2202004S64235Z00000X
NY016777-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist