Individual
CHRISTINA SHANNON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
400 BELCHASE DR STE 406, MATAWAN, NJ 07747-9760
(732) 851-6947
Mailing address
400 BELCHASE DR STE 406, MATAWAN, NJ 07747-9760
(732) 851-6947
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
14413934
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
471300603
SPEECH-LANGUAGE PATHOLOGY
NJ
Enumeration date
06/29/2021
Last updated
06/29/2021
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