Individual
SHANE FLETCHER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SPEECH PATHOLOGIST
Contact information
Practice address
1310 W ROOSEVELT BLVD, PHILADELPHIA, PA 19140-2033
(215) 329-8800
(215) 329-8808
Mailing address
1508 E BARRINGER ST, PHILADELPHIA, PA 19150-3302
(215) 329-8800
(215) 329-8808
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
SL010819
PA
Other
Enumeration date
05/13/2013
Last updated
05/13/2013
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