Provider Demographics
NPI:1932766516
Name:TOYE, SHANNON DALE (SLPA)
Entity Type:Individual
Prefix:
First Name:SHANNON
Middle Name:DALE
Last Name:TOYE
Suffix:
Gender:M
Credentials:SLPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109 FIELD CREST DR
Mailing Address - Street 2:
Mailing Address - City:SEARCY
Mailing Address - State:AR
Mailing Address - Zip Code:72143-8428
Mailing Address - Country:US
Mailing Address - Phone:501-322-3240
Mailing Address - Fax:
Practice Address - Street 1:1410 W DAISY L GATSON BATES DR
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72202-5434
Practice Address - Country:US
Practice Address - Phone:501-313-5181
Practice Address - Fax:501-897-6701
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-20
Last Update Date:2019-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language AssistantGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR210726742Medicaid