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General NPI Number Information
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NPI Number | 1518486448
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Entity Type | Individual
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Provider Name | SHAYNA GLATT MS CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 09/12/2017
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Last Update Date | 10/21/2021
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Provider Practice Location Address
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Address Line | 2480 E TOMPKINS AVE STE 222
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City | LAS VEGAS
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State | NV
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Zip | 89121-7625
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Country | US
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Telephone | 702-262-0037
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Fax |
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Provider Business Mailing Address
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Address Line | 14749 77TH AVE
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City | FLUSHING
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State | NY
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Zip | 11367-3123
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Country | US
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Telephone | 786-380-7414
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | SP-3151
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License Number State | NV
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