Healthcare Provider Details

I. General information

NPI: 1891940375
Provider Name (Legal Business Name): SHAUNA ANN FLYNN M.S., CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/25/2008
Last Update Date: 11/25/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 CEDAR STREET STE 302
NEW ROCHELLE NY
10801
US

IV. Provider business mailing address

14 SOUND VIEW AVENUE APT 2
YONKERS NY
10704
US

V. Phone/Fax

Practice location:
  • Phone: 914-576-5292
  • Fax:
Mailing address:
  • Phone: 917-855-6673
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number015630-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: