Provider Demographics
NPI:1437533262
Name:SHORTRIDGE, ADRIENNE COLE (MA, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:ADRIENNE
Middle Name:COLE
Last Name:SHORTRIDGE
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 1:1949 US 221 HWY N
Mailing Address - Street 2:
Mailing Address - City:RUTHERFORDTON
Mailing Address - State:NC
Mailing Address - Zip Code:28139-6607
Mailing Address - Country:US
Mailing Address - Phone:336-420-1899
Mailing Address - Fax:
Practice Address - Street 1:1949 US 221 HWY N
Practice Address - Street 2:
Practice Address - City:RUTHERFORDTON
Practice Address - State:NC
Practice Address - Zip Code:28139-6607
Practice Address - Country:US
Practice Address - Phone:336-420-1899
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-10
Last Update Date:2020-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC11402235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist