Individual
LYNNE SHANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
20 SCHOOL ST, BRADFORD, PA 16701-1257
(814) 362-7466
Mailing address
79 RODGAR LN, BRADFORD, PA 16701-2879
(814) 368-4806
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SL003810L
PA
Other
Enumeration date
03/16/2007
Last updated
07/08/2007
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