Provider Demographics
NPI:1740301852
Name:HORNBACH, SHANNON N
Entity type:Individual
Prefix:
First Name:SHANNON
Middle Name:N
Last Name:HORNBACH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:SHANNON
Other - Middle Name:N
Other - Last Name:STARNES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1 SPERTI DR
Mailing Address - Street 2:
Mailing Address - City:EDGEWOOD
Mailing Address - State:KY
Mailing Address - Zip Code:41017-9654
Mailing Address - Country:US
Mailing Address - Phone:859-344-9322
Mailing Address - Fax:859-344-9332
Practice Address - Street 1:1 SPERTI DR
Practice Address - Street 2:
Practice Address - City:EDGEWOOD
Practice Address - State:KY
Practice Address - Zip Code:41017-9654
Practice Address - Country:US
Practice Address - Phone:859-344-9322
Practice Address - Fax:859-344-9332
Is Sole Proprietor?:No
Enumeration Date:2007-04-03
Last Update Date:2015-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY06-066235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist