MEDICARE: MS. MARSHA JO HERSHMAN M.A., CCC-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
1	235Z00000X	Speech-Language Pathologist	41YS00067000	NJ

General Provider Information

NPI Number	:	1851415095
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MARSHA JO HERSHMAN M.A., CCC-SLP

Provider Business Mailing Address
First Line	:	51 DOVER DR
Second Line	:
City	:	LINDENWOLD
State	:	NJ
Zip	:	08021-6707
Country	:	US
Telephone Number	:	856-435-4326
Fax Number	:

Provider Business Practice Location Address
First Line	:	1415 MARLTON PIKE E
Second Line	:	SUITE 306
City	:	CHERRY HILL
State	:	NJ
Zip	:	08034-2210
Country	:	US
Telephone Number	:	856-354-1114
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/16/2007
Last Update Date	:	07/08/2007

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