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General NPI Number Information
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NPI Number | 1467419234
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Entity Type | Individual
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Provider Name | JUDITH ORRILL SHEA AU.D.
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Gender | Female
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Dates
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Enumeration Date | 04/27/2006
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Last Update Date | 12/26/2012
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Provider Practice Location Address
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Address Line | 415 HIGHLAND AVE SUITE 2
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City | CHESHIRE
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State | CT
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Zip | 06410-2563
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Country | US
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Telephone | 203-272-4512
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Fax | 203-272-4517
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Provider Business Mailing Address
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Address Line | 415 HIGHLAND AVE SUITE 2
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City | CHESHIRE
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State | CT
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Zip | 06410-2563
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Country | US
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Telephone | 203-272-4512
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Fax | 203-272-4517
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 231H00000X
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Taxonomy Name | Audiologist
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License Number | 000152
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 000707
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License Number State | CT
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Taxonomy #3
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Taxonomy Code | 237600000X
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Taxonomy Name | Audiologist-Hearing Aid Fitter
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License Number | 000152
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License Number State | CT
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