Provider Demographics
NPI:1912240136
Name:MCSHEA, JOYANNE (SLP-CCC)
Entity type:Individual
Prefix:
First Name:JOYANNE
Middle Name:
Last Name:MCSHEA
Suffix:
Gender:F
Credentials:SLP-CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1275 CLARKSON ST APT 7
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80218-1891
Mailing Address - Country:US
Mailing Address - Phone:720-215-7087
Mailing Address - Fax:
Practice Address - Street 1:1275 CLARKSON ST APT 7
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80218-1891
Practice Address - Country:US
Practice Address - Phone:720-215-7087
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-05
Last Update Date:2013-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO12087654235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist