Provider Demographics
NPI:1003158999
Name:HARTSHORNE, JUSTINE
Entity Type:Individual
Prefix:
First Name:JUSTINE
Middle Name:
Last Name:HARTSHORNE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JUSTINE
Other - Middle Name:A
Other - Last Name:NAGEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS-CCC-SLP
Mailing Address - Street 1:38431 HEMLOCK DR
Mailing Address - Street 2:
Mailing Address - City:FRANKFORD
Mailing Address - State:DE
Mailing Address - Zip Code:19945-4617
Mailing Address - Country:US
Mailing Address - Phone:412-889-7208
Mailing Address - Fax:
Practice Address - Street 1:31 HOSIER ST
Practice Address - Street 2:
Practice Address - City:SELBYVILLE
Practice Address - State:DE
Practice Address - Zip Code:19975-9300
Practice Address - Country:US
Practice Address - Phone:302-436-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-03-19
Last Update Date:2021-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL010769235Z00000X
235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist