Provider Demographics
NPI:1598431967
Name:DEVANEY, MOLLY LORRAINE (CF-SLP)
Entity Type:Individual
Prefix:
First Name:MOLLY
Middle Name:LORRAINE
Last Name:DEVANEY
Suffix:
Gender:F
Credentials:CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:230 DIVISION ST
Mailing Address - Street 2:
Mailing Address - City:MANAHAWKIN
Mailing Address - State:NJ
Mailing Address - Zip Code:08050-3130
Mailing Address - Country:US
Mailing Address - Phone:609-607-7400
Mailing Address - Fax:
Practice Address - Street 1:230 DIVISION ST
Practice Address - Street 2:
Practice Address - City:MANAHAWKIN
Practice Address - State:NJ
Practice Address - Zip Code:08050-3130
Practice Address - Country:US
Practice Address - Phone:609-607-7400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-17
Last Update Date:2021-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJTL-3638235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist