MEDICARE: KATHLEEN MICHELLE SHAFFER

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

General Provider Information

NPI Number	:	1386592731
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHLEEN MICHELLE SHAFFER

Provider Business Mailing Address
First Line	:	14606 DALLAS PKWY APT 1026
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75254-8836
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	14606 DALLAS PKWY APT 1026
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75254-8836
Country	:	US
Telephone Number	:	469-525-7523
Fax Number	:

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

Provider Enumeration Date	:	03/20/2026
Last Update Date	:	03/20/2026

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Directions to “ KATHLEEN MICHELLE SHAFFER ” Practice Location

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