Organization
SHORELINE PEDIATRIC NEUROPSYCHOLOGICAL SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHELLEY FRAZIER PELLETIER PH.D. (PEDIATRIC NEUROPSYCHOLOGY)
(860) 388-2000
Entity
Organization
Contact information
Practice address
954 MIDDLESEX TPKE, STE A2, OLD SAYBROOK, CT 06475-1302
(860) 388-2000
(860) 388-2000
Mailing address
PO BOX 303, OLD SAYBROOK, CT 06475
(860) 388-2000
(860) 388-2000
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
2736
CT
Other
Enumeration date
09/05/2007
Last updated
04/06/2015
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