Doctor Name: | MS. SHANNON NICHOLE O'BRIEN |
NPI Number: | 1043585599 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 0216001 |
Business Practice Address: | 455 Rawlinson Rd Rochester, NY - 146174841 |
Business Phone Number: | 5853364755 |
Business Fax Number: | |
Mailing Address: | 907 Goodman St S, ROCHESTER |
State: | NY |
Postal Code: | 146202525 |
Phone Number: | 5857461223 |
Fax Number: | |
NPI Enumeration Date: | 03/16/2012 |
NPI Last Update Date: | 03/16/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 0216001 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |