Healthcare Provider Details

I. General information

NPI: 1720924335
Provider Name (Legal Business Name): CASSANDRA NICHOLE SHEA MS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CASSIE NICHOLE SHEA MS

II. Dates (important events)

Enumeration Date: 04/27/2026
Last Update Date: 04/27/2026
Certification Date: 04/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 COMMERCIAL ST STE 1
SHARON MA
02067-1660
US

IV. Provider business mailing address

70 STORRS AVE
BRAINTREE MA
02184-4004
US

V. Phone/Fax

Practice location:
  • Phone: 781-290-3886
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number14366493
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: