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NPI Code Detail

MEDICARE: MS. SHANNON LYNN BISHOP M.S., CF-SLP

MEDICARE:  MS. SHANNON LYNN BISHOP  M.S., CF-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
1235Z00000XSpeech-Language PathologistTSLP10029AZ

General Provider Information

NPI Number : 1124572938
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. SHANNON LYNN BISHOP M.S., CF-SLP
Provider Business Mailing Address
First Line : 1350 S LINDSAY RD
Second Line :
City : MESA
State : AZ
Zip : 85204-6229
Country : US
Telephone Number : 480-472-6717
Fax Number :
Provider Business Practice Location Address
First Line : 1350 S LINDSAY RD
Second Line :
City : MESA
State : AZ
Zip : 85204-6229
Country : US
Telephone Number : 480-472-6717
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/09/2016
Last Update Date : 02/22/2023

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Directions to “ MS. SHANNON LYNN BISHOP M.S., CF-SLP” Practice Location

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