| Doctor Name: | SHIRLEY TENNYSON |
| NPI Number: | 1285771329 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | 4668 |
| Business Practice Address: | 20 Plaza West Cedarwood Hall Valhalla, NY - 105951681 |
| Business Phone Number: | 9144937274 |
| Business Fax Number: | 9144938190 |
| Mailing Address: | 480 Park Ave, Apt 3-j NEW YORK |
| State: | NY |
| Postal Code: | 100221613 |
| Phone Number: | 2126441688 |
| Fax Number: | 2123196049 |
| NPI Enumeration Date: | 01/30/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | 4668 |
| 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 |