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NPI Code Detail

MEDICARE: SHANNON MICHELLE HEINRICH MS, CCC-SLP

MEDICARE: SHANNON MICHELLE HEINRICH MS, 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
1235Z00000XSpeech-Language Pathologist12024653CO

General Provider Information

NPI Number : 1366970055
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHANNON MICHELLE HEINRICH MS, CCC-SLP
Provider Business Mailing Address
First Line : 12975 SHERIDAN BLVD
Second Line :
City : BROOMFIELD
State : CO
Zip : 80020-1477
Country : US
Telephone Number : 720-468-3695
Fax Number :
Provider Business Practice Location Address
First Line : 12975 SHERIDAN BLVD
Second Line :
City : BROOMFIELD
State : CO
Zip : 80020-1477
Country : US
Telephone Number : 720-468-3695
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/25/2017
Last Update Date : 07/21/2022

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Directions to “ SHANNON MICHELLE HEINRICH MS, CCC-SLP” Practice Location

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