Doctor Name: | SHANEE FULTON |
NPI Number: | 1073856654 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.S. |
License Number: | 024243 |
Business Practice Address: | 50 Myano Ln Unit 8 Stamford, CT - 069024598 |
Business Phone Number: | 2035456455 |
Business Fax Number: | |
Mailing Address: | 50 Myano Ln, Unit 8 STAMFORD |
State: | CT |
Postal Code: | 069024598 |
Phone Number: | 2035456455 |
Fax Number: | |
NPI Enumeration Date: | 04/01/2013 |
NPI Last Update Date: | 10/15/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 024243 |
Healthcare Provider Taxonomy: (Secondary) | N |
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 |