Provider Demographics
NPI:1841463296
Name:HENNING, SHELLI LYNN (MSCCCSLP)
Entity type:Individual
Prefix:MRS
First Name:SHELLI
Middle Name:LYNN
Last Name:HENNING
Suffix:
Gender:F
Credentials:MSCCCSLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1531 AMELIA AVE
Mailing Address - Street 2:
Mailing Address - City:SOUTH PARK
Mailing Address - State:PA
Mailing Address - Zip Code:15129-9633
Mailing Address - Country:US
Mailing Address - Phone:412-537-2169
Mailing Address - Fax:
Practice Address - Street 1:1350 OLD FREEPORT RD
Practice Address - Street 2:SUTIE 2AR
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15238-3122
Practice Address - Country:US
Practice Address - Phone:412-963-0463
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-07
Last Update Date:2008-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL007539235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist