Provider Demographics
NPI:1962830729
Name:SHOIMER, RENATA (CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:RENATA
Middle Name:
Last Name:SHOIMER
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 1:2 FOXTAIL LN
Mailing Address - Street 2:
Mailing Address - City:MONMOUTH JUNCTION
Mailing Address - State:NJ
Mailing Address - Zip Code:08852-2005
Mailing Address - Country:US
Mailing Address - Phone:732-329-0725
Mailing Address - Fax:
Practice Address - Street 1:2 FOXTAIL LN
Practice Address - Street 2:
Practice Address - City:MONMOUTH JUNCTION
Practice Address - State:NJ
Practice Address - Zip Code:08852-2005
Practice Address - Country:US
Practice Address - Phone:732-329-0725
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-14
Last Update Date:2013-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL011650235Z00000X
NJ41YS00736100235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist