Provider Demographics
NPI:1649625609
Name:SHELINE, RENEE O'NEILL (MA, CCC-SLP)
Entity type:Individual
Prefix:
First Name:RENEE
Middle Name:O'NEILL
Last Name:SHELINE
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:RENEE
Other - Middle Name:ALANE
Other - Last Name:O'NEILL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, CCC-SLP
Mailing Address - Street 1:22820 FLORAL ST
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:MI
Mailing Address - Zip Code:48336-4222
Mailing Address - Country:US
Mailing Address - Phone:248-767-2911
Mailing Address - Fax:
Practice Address - Street 1:3145 W CLARK RD STE 106
Practice Address - Street 2:
Practice Address - City:YPSILANTI
Practice Address - State:MI
Practice Address - Zip Code:48197-1197
Practice Address - Country:US
Practice Address - Phone:734-712-0566
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-27
Last Update Date:2019-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
No247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other