MEDICARE: MRS. SHAWNA LEA BROWNING-WALLACE MA CCC-SLP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	SA15073	FL

General Provider Information

NPI Number	:	1043394307
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. SHAWNA LEA BROWNING-WALLACE MA CCC-SLP

Provider Business Mailing Address
First Line	:	957 WATEROAK DR NE
Second Line	:
City	:	PALM BAY
State	:	FL
Zip	:	32905-4694
Country	:	US
Telephone Number	:	321-795-8229
Fax Number	:

Provider Business Practice Location Address
First Line	:	587 BARTON BLVD
Second Line	:
City	:	ROCKLEDGE
State	:	FL
Zip	:	32955-3145
Country	:	US
Telephone Number	:	321-632-6300
Fax Number	:	321-632-6300

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/24/2006
Last Update Date	:	10/23/2025

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