Individual
SHANNON NICHOLLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
377 UNION AVE, BRIDGEWATER, NJ 08807-3108
(908) 725-2366
Mailing address
28 PUTNAM ST, SOMERVILLE, NJ 08876-2737
(732) 453-4036
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
41YS01017000
NJ
Other
Enumeration date
11/20/2019
Last updated
12/23/2019
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