Provider Demographics
NPI:1881866598
Name:SCRIBNER, SHONA
Entity Type:Individual
Prefix:
First Name:SHONA
Middle Name:
Last Name:SCRIBNER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:85 SEYMOUR ST
Mailing Address - Street 2:STE 815
Mailing Address - City:HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06106-5527
Mailing Address - Country:US
Mailing Address - Phone:860-972-2585
Mailing Address - Fax:860-545-3755
Practice Address - Street 1:80 SEYMOUR ST
Practice Address - Street 2:
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06102-8000
Practice Address - Country:US
Practice Address - Phone:860-972-2585
Practice Address - Fax:860-545-3755
Is Sole Proprietor?:No
Enumeration Date:2008-04-02
Last Update Date:2019-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013611235Z00000X
CT003154363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist