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1841356565 NPI number — SHANNON MITCHELL SMITH MS CCCSLP

NPI Number: 1841356565
Health Care Provider/Practitioner: SHANNON MITCHELL SMITH MS CCCSLP

Information about “1841356565” NPI (SHANNON MITCHELL SMITH MS CCCSLP) exists in 1841356565 in HTML format HTML  |  1841356565 in plain Text format TXT  |  1841356565 in PDF (Portable Document Format) PDF  |  1841356565 in an XML format XML  formats.

NPI Number : 1841356565 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1841356565",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "SMITH",
    "FirstName": "SHANNON",
    "MiddleName": "MITCHELL",
    "NamePrefix": "MRS.",
    "NameSuffix": null,
    "Credential": "MS CCCSLP",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "GARDNER",
    "OtherFirstName": "SHANNON",
    "OtherMiddleName": "MITCHELL",
    "OtherNamePrefix": "MRS.",
    "OtherNameSuffix": null,
    "OtherCredential": "SLP",
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "8005 FALLMEADOW CIR",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "PLANO",
    "MailingAddressStateName": "TX",
    "MailingAddressPostalCode": "75024-6850",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "972-342-9513",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "8005 FALLMEADOW CIR",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "PLANO",
    "PracticeLocationAddressStateName": "TX",
    "PracticeLocationAddressPostalCode": "75024-6850",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "972-342-9513",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "12/28/2006",
    "LastUpdateDate": "06/12/2014",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "235Z00000X",
        "TaxonomyName": "Speech-Language Pathologist",
        "LicenseNumber": "16173",
        "LicenseNumberStateCode": "TX",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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