Individual
MS. SHANNON M DUFFY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
295 VARNUM AVE, LOWELL, MA 01854-2193
(978) 937-6000
Mailing address
395 EDWARD J ROY DR APT 209, MANCHESTER, NH 03104-4155
(603) 620-9996
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
2228
NH
235Z00000X
Speech-Language Pathologist
Primary
78053
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14394506
AMERICAN SPEECH-LANGUAGE AND HEARING ASSOCIATION
—
01
—
2228
OFFICE OF LICENSED ALLIED HEALTH PROFESSIONALS
NH
01
—
78053
BOARD OF SPEECH-LANGUAGE PATHOLOGY AND AUDIOLOGY
MA
Enumeration date
12/13/2022
Last updated
12/13/2022
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