Individual
SHANNON DIANE SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
107B N UNION AVE, CRANFORD, NJ 07016-2371
(908) 272-3400
Mailing address
38 NORMANDIE PL, CRANFORD, NJ 07016-1960
(908) 967-8244
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
TL-3647
NJ
Other
Enumeration date
08/19/2021
Last updated
08/19/2021
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