MEDICARE: MRS. SHANNON SHIRLEY HAYS M.S. - 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
1	235Z00000X	Speech-Language Pathologist	06207	MD

General Provider Information

NPI Number	:	1962701623
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. SHANNON SHIRLEY HAYS M.S. - CCC/SLP

Provider Business Mailing Address
First Line	:	164 W MAIN ST
Second Line	:	SUITE A
City	:	NEW MARKET
State	:	MD
Zip	:	21774-6279
Country	:	US
Telephone Number	:	301-606-8278
Fax Number	:	301-865-8178

Provider Business Practice Location Address
First Line	:	164 W MAIN ST
Second Line	:	SUITE A
City	:	NEW MARKET
State	:	MD
Zip	:	21774-6279
Country	:	US
Telephone Number	:	301-606-8278
Fax Number	:	301-865-8178

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

Provider Enumeration Date	:	03/21/2011
Last Update Date	:	03/21/2011

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