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NPI Code Detail

MEDICARE: SHANNON MARIE COLLIER SLP

MEDICARE: SHANNON MARIE COLLIER SLP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1235Z00000XSpeech-Language Pathologist10211NC

General Provider Information

NPI Number : 1134407885
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHANNON MARIE COLLIER SLP
Provider Business Mailing Address
First Line : 58 OFFICE PARK DR
Second Line :
City : JACKSONVILLE
State : NC
Zip : 28546-3218
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 58 OFFICE PARK DR
Second Line :
City : JACKSONVILLE
State : NC
Zip : 28546-3218
Country : US
Telephone Number : 910-395-2995
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/29/2011
Last Update Date : 01/10/2013

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Directions to “ SHANNON MARIE COLLIER SLP” Practice Location

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