Individual
SHANNON SPENCER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
333 BLOOMFIELD AVE STE 102, CALDWELL, NJ 07006-5167
(973) 364-0804
Mailing address
801 MADISON ST APT 6N, HOBOKEN, NJ 07030-6440
(607) 423-0088
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
TL-3432
NJ
Other
Enumeration date
08/31/2020
Last updated
08/31/2020
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