MEDICARE: MRS. SHAWNA NESS SHOVELIN M.A., 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	SLP1297	AZ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1396960712
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. SHAWNA NESS SHOVELIN M.A., CCC-SLP

Provider Business Mailing Address
First Line	:	2021 E WINSTON DR
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85042-8139
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2021 E WINSTON DR
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85042-8139
Country	:	US
Telephone Number	:	602-268-0338
Fax Number	:

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

Provider Enumeration Date	:	04/13/2007
Last Update Date	:	07/08/2007

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