Provider Demographics
NPI:1912150251
Name:DWYER-HONEYWELL, SHELBY J
Entity Type:Individual
Prefix:MRS
First Name:SHELBY
Middle Name:J
Last Name:DWYER-HONEYWELL
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 1:34 SAND ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:NY
Mailing Address - Zip Code:13673-3205
Mailing Address - Country:US
Mailing Address - Phone:315-642-0035
Mailing Address - Fax:
Practice Address - Street 1:34 SAND ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:NY
Practice Address - Zip Code:13673-3205
Practice Address - Country:US
Practice Address - Phone:315-642-0035
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-30
Last Update Date:2008-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0137321235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist