Shannon Waller
Shannon Waller is a Speech-Language Pathologist in Grand Rapids, Michigan. Licensed in Michigan. Registered with an NPI since 2022.
- Licensed in
- MI
- In the registry since
- 2022
- Specialties on file
- 2
Practice location Address checks out
235 Wealthy St SEGrand Rapids, MI 49503-5247
Phone: (800) 528-8989
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Speech-Language Pathologist (primary) | Taxonomy 235Z00000X (MI) |
|---|---|
| Speech-Language Pathologist | Taxonomy 235Z00000X · Licence 7101001306 (MI) |
Record details
| NPI number | 1053044537 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Female |
| Sole proprietor | No |
| NPI enumerated | July 2, 2022 |
| Last updated in NPPES | July 2, 2022 |
| Certification date | July 1, 2022 |
| Mailing address | 235 Wealthy St Se, Grand Rapids, MI 49503-5247 |
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