Provider Demographics
NPI:1508560384
Name:PAUL, SHIANNE
Entity type:Individual
Prefix:
First Name:SHIANNE
Middle Name:
Last Name:PAUL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30A G RYDER RD
Mailing Address - Street 2:
Mailing Address - City:DEVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:71328-9100
Mailing Address - Country:US
Mailing Address - Phone:318-955-3204
Mailing Address - Fax:
Practice Address - Street 1:1515 LA-107
Practice Address - Street 2:
Practice Address - City:CENTERPOINT
Practice Address - State:LA
Practice Address - Zip Code:71323
Practice Address - Country:US
Practice Address - Phone:318-253-4601
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-28
Last Update Date:2023-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist