Provider Demographics
NPI:1770132318
Name:MCLAUGHLIN, SHANNON CATHERINE
Entity type:Individual
Prefix:
First Name:SHANNON
Middle Name:CATHERINE
Last Name:MCLAUGHLIN
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 1:370 WASHINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:PLEASANTVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:10570-1627
Mailing Address - Country:US
Mailing Address - Phone:914-610-8129
Mailing Address - Fax:
Practice Address - Street 1:370 WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:PLEASANTVILLE
Practice Address - State:NY
Practice Address - Zip Code:10570-1627
Practice Address - Country:US
Practice Address - Phone:914-610-8129
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-06
Last Update Date:2022-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY030668235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist