Doctor Name: | MRS. SALLY ELLEN CONNOLLY |
NPI Number: | 1164727178 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MS, CCC-SLP |
License Number: | 003562 |
Business Practice Address: | 5893 Main St Trumbull, CT - 066112448 |
Business Phone Number: | 2032688852 |
Business Fax Number: | |
Mailing Address: | 5893 Main St, TRUMBULL |
State: | CT |
Postal Code: | 066112448 |
Phone Number: | 2032688852 |
Fax Number: | |
NPI Enumeration Date: | 01/21/2011 |
NPI Last Update Date: | 01/21/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 003562 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CT |
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 |