Shannon Colleen Wisocky, MA
Individual provider Active NPI Speech-Language Pathologist · Slatington, PA
NPI 1780118521 · NPPES record last updated Apr 19, 2017
Key facts
- NPI
- 1780118521
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- SL006206L (PA)
- Practice address
- 4213 Cider Press Rd
Slatington, PA 18080-3158 - Phone
- (610) 217-7482
- NPI assigned
- Apr 19, 2017
- 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)
- No
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SL006206L | PA | MD | Speech-Language Pathologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | SL006206L | PA | Yes |
Addresses
Primary practice location
4213 Cider Press Rd
Slatington, PA 18080-3158
Mailing address
4213 Cider Press Rd
Slatington, PA 18080-3158
Other providers in Slatington, PA
- Scott T Vanduzer
- Stephanie Kristine Vanduzer
- Shannon R Vaught
- Elexus Wilson
- Mary Wiseman
- Hannah M Wittman
- Gallus Wukitsch
- Kyle Zehner
All providers in Slatington, 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 19, 2017. 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.