Doctor Name: | MR. BERNARD DENNIS SHAW |
NPI Number: | 1225148604 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MED |
License Number: | SL000187L |
Business Practice Address: | 1951 Shenango Valley Freeway Hermitage, PA - 161482522 |
Business Phone Number: | 7243472005 |
Business Fax Number: | 7243474484 |
Mailing Address: | 1951 Shenango Valley Freeway, HERMITAGE |
State: | PA |
Postal Code: | 161482522 |
Phone Number: | 7243472005 |
Fax Number: | 7243474484 |
NPI Enumeration Date: | 08/30/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | SL000187L |
Healthcare Provider Taxonomy: (Secondary) | X |
State: | PA |
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 |