Provider Demographics
NPI:1235318148
Name:SHAW, SHEKIRA KAMALI (SLP)
Entity type:Individual
Prefix:MS
First Name:SHEKIRA
Middle Name:KAMALI
Last Name:SHAW
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13508 BLYTHEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:SPRING HILL
Mailing Address - State:FL
Mailing Address - Zip Code:34609-0715
Mailing Address - Country:US
Mailing Address - Phone:352-688-8945
Mailing Address - Fax:
Practice Address - Street 1:13508 BLYTHEWOOD DR
Practice Address - Street 2:
Practice Address - City:SPRING HILL
Practice Address - State:FL
Practice Address - Zip Code:34609-0715
Practice Address - Country:US
Practice Address - Phone:352-688-8945
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-26
Last Update Date:2007-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA9200235Z00000X
NY017062235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist