Provider Demographics
NPI:1831489251
Name:HARLOW, SHAUNA MARIE (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:SHAUNA
Middle Name:MARIE
Last Name:HARLOW
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 1:111 DOGWOOD LN
Mailing Address - Street 2:
Mailing Address - City:ALLEN
Mailing Address - State:KY
Mailing Address - Zip Code:41601-9533
Mailing Address - Country:US
Mailing Address - Phone:606-946-6173
Mailing Address - Fax:
Practice Address - Street 1:111 DOGWOOD LN
Practice Address - Street 2:
Practice Address - City:ALLEN
Practice Address - State:KY
Practice Address - Zip Code:41601-9533
Practice Address - Country:US
Practice Address - Phone:606-946-6173
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-19
Last Update Date:2011-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3896235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist