Healthcare Provider Details

I. General information

NPI: 1891131256
Provider Name (Legal Business Name): SHANE LINDSEY FLETCHER M.S. CCC-SLP/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/13/2013
Last Update Date: 08/28/2026
Certification Date: 08/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 W MAIN ST
CHRISTIANA DE
19702-1585
US

IV. Provider business mailing address

26 VILONE RD
WILMINGTON DE
19805-2003
US

V. Phone/Fax

Practice location:
  • Phone: 302-454-2131
  • Fax:
Mailing address:
  • Phone: 267-259-9338
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberO1-0012182
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: