Provider Demographics
NPI:1467127621
Name:SCULLIN, SALINA MARIE (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:SALINA
Middle Name:MARIE
Last Name:SCULLIN
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:220 WALLING PL
Mailing Address - Street 2:
Mailing Address - City:NORTH MIDDLETOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07748-6007
Mailing Address - Country:US
Mailing Address - Phone:732-927-3378
Mailing Address - Fax:
Practice Address - Street 1:1041 ROUTE 36
Practice Address - Street 2:
Practice Address - City:ATLANTIC HIGHLANDS
Practice Address - State:NJ
Practice Address - Zip Code:07716-2533
Practice Address - Country:US
Practice Address - Phone:732-788-3502
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-10
Last Update Date:2021-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YS00611700235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist