Organization
SHORELINE PEDIATRIC NEUROPSYCHOLOGICAL SERVICES, LLC
Active
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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