Provider Demographics
NPI:1811305030
Name:SHANK, AIMEE
Entity type:Individual
Prefix:MRS
First Name:AIMEE
Middle Name:
Last Name:SHANK
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 1:227 LOYALSOCK DR
Mailing Address - Street 2:
Mailing Address - City:DOUGLASSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19518-8729
Mailing Address - Country:US
Mailing Address - Phone:610-385-4505
Mailing Address - Fax:
Practice Address - Street 1:4210 INDEPENDENCE DR
Practice Address - Street 2:
Practice Address - City:SCHNECKSVILLE
Practice Address - State:PA
Practice Address - Zip Code:18078-2580
Practice Address - Country:US
Practice Address - Phone:610-769-4111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-31
Last Update Date:2014-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist