Shelley Driscoll
Individual provider Active NPI Speech-Language Pathologist · Pemberton, NJ
NPI 1003318155 · NPPES record last updated Mar 17, 2018
Key facts
- NPI
- 1003318155
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- 41YS00649200 (NJ)
- Practice address
- 43 Elizabeth St
Pemberton, NJ 08068-1232 - Phone
- (609) 316-0195
- Fax
- (609) 353-1549
- NPI assigned
- Mar 5, 2018
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 41YS00649200 | NJ | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Exceptional Kidz Rehabilitation | Speech-Language Pathologist | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 41YS00649200 | NJ | Yes |
Addresses
Primary practice location
43 Elizabeth St
Pemberton, NJ 08068-1232
Mailing address
43 Elizabeth St
Pemberton, NJ 08068-1232
Phone (609) 316-0195
Other practice location 1
527 Wrightstown Sykesville Rd Unit 15
Wrightstown, NJ 08562-1530
Phone (609) 316-0195
Other providers in Pemberton, NJ
- Gabrielle Defilippo
- John Delvacchio
- Margaret Derogatis
- Amy Dickinson
- Morgan Draham
- Adelisa Durakovic
- Exceptional Kidz Rehabilitation
- Sarah Fabian
- Cynthia Fabritz
- Friends of Cyrus II
All providers in Pemberton, NJ · Speech-Language Pathologist in New Jersey
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 17, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.