Shannon M Keyes, M.S., CCC-SLP

Individual provider Active NPI Speech-Language Pathologist · Lacona, NY

NPI 1992958276 · NPPES record last updated May 1, 2012

Key facts

NPI
1992958276
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
016192-1 (NY)
Practice address
7018 County Route 17
Lacona, NY 13083-4107
Phone
(315) 387-6395
NPI assigned
Oct 30, 2008
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 Science

State licenses

LicenseStateTypeSpecialty
016192-1NYMDSpeech-Language Pathologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 016192-1 NY Yes

Addresses

Primary practice location

7018 County Route 17
Lacona, NY 13083-4107

Mailing address

7018 County Route 17
Lacona, NY 13083-4107
Phone (315) 387-6395

Other providers in Lacona, NY

All providers in Lacona, NY · Speech-Language Pathologist in New York

Sources for this page

Verify at the official NPI Registry.