Provider Demographics
NPI:1265696942
Name:EARL, SHANNON KATHRYN
Entity type:Individual
Prefix:MS
First Name:SHANNON
Middle Name:KATHRYN
Last Name:EARL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:SHANNON
Other - Middle Name:K
Other - Last Name:SOLSOCINSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4494 ZENNER RD
Mailing Address - Street 2:
Mailing Address - City:EDEN
Mailing Address - State:NY
Mailing Address - Zip Code:14057
Mailing Address - Country:US
Mailing Address - Phone:716-997-1411
Mailing Address - Fax:
Practice Address - Street 1:960 WEST MAPLE CT
Practice Address - Street 2:
Practice Address - City:ELMA
Practice Address - State:NY
Practice Address - Zip Code:14059
Practice Address - Country:US
Practice Address - Phone:716-805-1440
Practice Address - Fax:716-805-1441
Is Sole Proprietor?:No
Enumeration Date:2008-07-11
Last Update Date:2009-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist