Provider Demographics
NPI:1942542188
Name:BIELICH, SHOSHANA DANA (MSCCCSLP)
Entity Type:Individual
Prefix:MRS
First Name:SHOSHANA
Middle Name:DANA
Last Name:BIELICH
Suffix:
Gender:F
Credentials:MSCCCSLP
Other - Prefix:
Other - First Name:SHOSHANA
Other - Middle Name:DANA
Other - Last Name:AUSPITZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSCCCSLP
Mailing Address - Street 1:11990 LAKE TRAIL LN
Mailing Address - Street 2:
Mailing Address - City:PARKLAND
Mailing Address - State:FL
Mailing Address - Zip Code:33076-2993
Mailing Address - Country:US
Mailing Address - Phone:954-804-5061
Mailing Address - Fax:
Practice Address - Street 1:2950 CLEVELAND CLINIC BLVD
Practice Address - Street 2:
Practice Address - City:WESTON
Practice Address - State:FL
Practice Address - Zip Code:33331-3625
Practice Address - Country:US
Practice Address - Phone:954-659-5786
Practice Address - Fax:954-659-5787
Is Sole Proprietor?:No
Enumeration Date:2013-03-26
Last Update Date:2021-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA11985235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist