Provider Demographics
NPI:1447070552
Name:SHANDS, DAWN RAE (SLP)
Entity type:Individual
Prefix:
First Name:DAWN
Middle Name:RAE
Last Name:SHANDS
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:DAWN
Other - Middle Name:RAE
Other - Last Name:MARSH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7836 PITTMAN RD
Mailing Address - Street 2:
Mailing Address - City:ADKINS
Mailing Address - State:TX
Mailing Address - Zip Code:78101-2508
Mailing Address - Country:US
Mailing Address - Phone:210-319-8526
Mailing Address - Fax:
Practice Address - Street 1:7173 FM 1628
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78263-9621
Practice Address - Country:US
Practice Address - Phone:210-634-7100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-14
Last Update Date:2024-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX122946235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist