Individual
NICOLE SHANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S., CCC-SLP
Contact information
Practice address
205 BAKERS RIDGE RD, MORGANTOWN, WV 26508-1500
(304) 598-4300
Mailing address
1225 MEADOWBROOK DR, CANONSBURG, PA 15317-5000
(412) 576-2766
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP-2112
WV
Other
Enumeration date
07/16/2020
Last updated
07/16/2020
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