Shannon Nicole Gaylord, MA,CCC-SLP

Individual provider Active NPI Speech-Language Pathologist · Willows, CA

NPI 1134817802 · NPPES record last updated Apr 28, 2023

Key facts

NPI
1134817802
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
12943 (CA)
Practice address
1133 W Sycamore St
Willows, CA 95988-2601
Phone
(530) 934-1832
NPI assigned
Apr 28, 2023
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
12943CAMDOccupational Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 12943 CA Yes

Addresses

Primary practice location

1133 W Sycamore St
Willows, CA 95988-2601

Mailing address

1241 Salem St
Chico, CA 95928-6550
Phone (530) 370-4383

Other providers in Willows, CA

All providers in Willows, CA · Speech-Language Pathologist in California

Sources for this page

Verify at the official NPI Registry.