Provider Demographics
NPI:1487952396
Name:SMITH, SHON FLOWERS (MSP, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:SHON
Middle Name:FLOWERS
Last Name:SMITH
Suffix:
Gender:F
Credentials:MSP, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:549 ELZIE HALLMAN RD
Mailing Address - Street 2:
Mailing Address - City:LEESVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29070-9723
Mailing Address - Country:US
Mailing Address - Phone:803-767-6972
Mailing Address - Fax:
Practice Address - Street 1:549 ELZIE HALLMAN RD
Practice Address - Street 2:
Practice Address - City:LEESVILLE
Practice Address - State:SC
Practice Address - Zip Code:29070-9723
Practice Address - Country:US
Practice Address - Phone:803-767-6972
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-02
Last Update Date:2011-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3086235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist