Joanne Distilo-Shannon, SLP
Individual provider Active NPI Speech-Language Pathologist · Glenshaw, PA
NPI 1497067078 · NPPES record last updated Apr 8, 2021
Key facts
- NPI
- 1497067078
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- SL007734 (PA)
- Practice address
- 106 Woodland Ave
Glenshaw, PA 15116-2009 - Phone
- (215) 519-8917
- NPI assigned
- Jul 12, 2010
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 018680 | NY | MD | Clinical Psychologist |
| 018680-1 | NY | MD | Speech-Language Pathologist |
| SL007734 | PA | MD | Speech-Language Pathologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 018680-1 | NY | |
| Speech-Language Pathologist | 235Z00000X | SL007734 | PA | Yes |
Addresses
Primary practice location
106 Woodland Ave
Glenshaw, PA 15116-2009
Mailing address
106 Woodland Ave
Glenshaw, PA 15116-2009
Phone (215) 519-8917
Other names
- Joanne Gregory
Other providers in Glenshaw, PA
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- Mary-Jo Dickinson
- Dietitian Jess Nutrition
- Kimberly Digiacobbe
- Joseph Rocco Direnzo
- Valerie P Donaldson
- Holly Donovan
- Morgan Dougherty
- Amanda Durham
- Sarah Marie Eckels
All providers in Glenshaw, PA · Speech-Language Pathologist in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 8, 2021. 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.