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General NPI Number Information
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NPI Number | 1609024322
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Entity Type | Individual
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Provider Name | ANDREW TYSON SHAFFNER MA SLP-CCC
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Gender | Male
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Dates
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Enumeration Date | 09/05/2008
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Last Update Date | 04/23/2018
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Provider Practice Location Address
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Address Line | 1 GLENSHIRE LN
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City | CHICO
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State | CA
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Zip | 95973-1072
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Country | US
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Telephone | 530-894-1022
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Fax |
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Provider Business Mailing Address
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Address Line | 1840 MOSURE LN
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City | PARADISE
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State | CA
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Zip | 95969-6016
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Country | US
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Telephone | 530-514-0546
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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 | SP15424
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License Number State | CA
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