Healthcare Provider Details

I. General information

NPI: 1487569554
Provider Name (Legal Business Name): SHANNON FINN CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/14/2026
Last Update Date: 08/14/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1069 RINGWOOD AVE STE 217
HASKELL NJ
07420-1451
US

IV. Provider business mailing address

1069 RINGWOOD AVE STE 217
HASKELL NJ
07420-1451
US

V. Phone/Fax

Practice location:
  • Phone: 201-669-8647
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number41YS01405300
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: