Individual
SHANNON DOLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, CCC-SLP
Contact information
Practice address
3914 W TAPPS DR E, LAKE TAPPS, WA 98391-9176
(585) 474-9916
Mailing address
620 BELL RD, NEWARK, NY 14513-8804
(585) 474-9916
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
14242977
—
Other
Enumeration date
09/15/2022
Last updated
09/15/2022
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