Provider Demographics
NPI:1205627247
Name:MAY, SHANIE BREANN (CF-SLP)
Entity type:Individual
Prefix:
First Name:SHANIE
Middle Name:BREANN
Last Name:MAY
Suffix:
Gender:F
Credentials:CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:180 CIRCLE DR
Mailing Address - Street 2:
Mailing Address - City:HERRIN
Mailing Address - State:IL
Mailing Address - Zip Code:62948-4302
Mailing Address - Country:US
Mailing Address - Phone:618-967-5973
Mailing Address - Fax:
Practice Address - Street 1:245 MAGNOLIA DR
Practice Address - Street 2:
Practice Address - City:GLEN CARBON
Practice Address - State:IL
Practice Address - Zip Code:62034-1605
Practice Address - Country:US
Practice Address - Phone:618-685-2259
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-16
Last Update Date:2025-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program