Provider Demographics
NPI:1013156355
Name:SHELDON, JENNIFER (ST)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:SHELDON
Suffix:
Gender:F
Credentials:ST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 GARRISON CT
Mailing Address - Street 2:
Mailing Address - City:MARLTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08053-5328
Mailing Address - Country:US
Mailing Address - Phone:609-230-6483
Mailing Address - Fax:
Practice Address - Street 1:2 GARRISON CT
Practice Address - Street 2:
Practice Address - City:MARLTON
Practice Address - State:NJ
Practice Address - Zip Code:08053-5328
Practice Address - Country:US
Practice Address - Phone:609-230-6483
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-02-10
Last Update Date:2014-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL009444235Z00000X
NJSL00944235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist