Provider Demographics
NPI:1003438029
Name:FRYE, SHANNON HALEY (AUD)
Entity Type:Individual
Prefix:DR
First Name:SHANNON
Middle Name:HALEY
Last Name:FRYE
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:SHANNON
Other - Middle Name:HALEY
Other - Last Name:O'NEIL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:59 PAGE HILL RD
Mailing Address - Street 2:
Mailing Address - City:BERLIN
Mailing Address - State:NH
Mailing Address - Zip Code:03570-3542
Mailing Address - Country:US
Mailing Address - Phone:603-752-2200
Mailing Address - Fax:
Practice Address - Street 1:59 PAGE HILL RD
Practice Address - Street 2:
Practice Address - City:BERLIN
Practice Address - State:NH
Practice Address - Zip Code:03570-3542
Practice Address - Country:US
Practice Address - Phone:603-752-2200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-13
Last Update Date:2020-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist