Most Relevant Information
Provider Data
| NPI Number: | 1003422601 |
| Provider Name: | SHEA CARNES M.S., CCC-SLP |
| Entity Type: | Individual |
| Taxonomy Code: | 235Z00000X |
| Specialty: | Speech-Language Pathologist |
| License Number: | TSLP12504 |
Most Important Dates
| Enumeration Date: | 09/18/2020 |
| Last Updated: | 02/23/2023 |
Provider Practice Location
300 E GURLEY ST
PRESCOTT
AZ
863013823
Practice Location Phone/Fax
| Phone: | 9287173236 |
| Fax: |
Provider Mailing Location
202 SAN CARLOS RD
PRESCOTT
AZ
863033741
Provider Mailing Phone/Fax
| Phone: | 9288309973 |
| Fax: |