Provider Demographics
NPI:1447543178
Name:REIL, SHEA DENISE (MS CCC SLP)
Entity type:Individual
Prefix:MRS
First Name:SHEA
Middle Name:DENISE
Last Name:REIL
Suffix:
Gender:F
Credentials:MS CCC SLP
Other - Prefix:
Other - First Name:SHEA
Other - Middle Name:DENISE
Other - Last Name:OLSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS CCC SLP
Mailing Address - Street 1:1001 SOUTH ST
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68502-2251
Mailing Address - Country:US
Mailing Address - Phone:402-441-7101
Mailing Address - Fax:402-438-0845
Practice Address - Street 1:1001 SOUTH ST
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68502-2251
Practice Address - Country:US
Practice Address - Phone:402-441-7101
Practice Address - Fax:402-438-0845
Is Sole Proprietor?:No
Enumeration Date:2011-05-27
Last Update Date:2011-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1094235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist