Russell, Shane Renee
Russell, Shane Renee is an sole proprietor health care provider with primary practice located at 247 Sw Long Leaf Dr , Lake City FL 32024-4241. She recently has only one registered license in Speech, Language and Hearing Service Providers / Speech-Language Pathologist, which is considered as her primary health care specialty. Russell, Shane Renee can be contacted via phone (386) 752-3274.Contact Information
Primary practice address
247 Sw Long Leaf Dr
Lake City FL 32024-4241
Phone: (386) 752-3274
Fax:
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Speech, Language and Hearing Service Providers / Speech-Language Pathologist | 235Z00000X | SA7504 | Florida |
Profile Details
NPI number | 1548361850 |
---|---|
LBN Legal business name | Russell, Shane Renee |
Credentials | MS CCC-SLP |
Entity | Individual |
Sole proprietor 1 | Yes |
Enumeration date | Sep 26th, 2006 |
Last updated | Jul 9th, 2007 - about 18 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1548361850 | NPPES |
Florida | MEDICAID | 89142810000 |
Popular Providers
-
Tomassini, Daisy J
871 Sw State Road 47 , Lake City FL 32025-0433 -
Saintvil, Jean Denis
587 Se Ermine Ave , Lake City FL 32025-6126 -
Croft, Alecia
786 Se Peacock Ter , Lake City FL 32025-8241 -
Widergren, Sheila
298 Nw Country Lake Gln , Lake City FL 32055-8549 -
Mobley, Brandy J
359 W Duval St , Lake City FL 32055-3991 -
Hunt, Kelli Lynn
608 Sw Marvin Burnett Rd , Lake City FL 32025-4918 -
Murray, Natalie K
578 E Duval St , Lake City FL 32055-3471 -
Murphy, Beth A
203 Sw Aurora Way , Lake City FL 32025-0462