Provider Demographics
NPI:1265632624
Name:SHARKEY, JUNNIE ANNE (MA CCC/SLP)
Entity Type:Individual
Prefix:MRS
First Name:JUNNIE
Middle Name:ANNE
Last Name:SHARKEY
Suffix:
Gender:F
Credentials:MA CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:72 SUNSET AVE
Mailing Address - Street 2:
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08755-3254
Mailing Address - Country:US
Mailing Address - Phone:732-349-9155
Mailing Address - Fax:
Practice Address - Street 1:CHILDREN'S SPECIALIZED HOSPITAL
Practice Address - Street 2:310 MAIN STREET
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08753
Practice Address - Country:US
Practice Address - Phone:732-281-3918
Practice Address - Fax:732-281-3919
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-23
Last Update Date:2007-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YS00211100235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist