National Provider Identifier

Jacqueline Marie Shellum

Jacqueline Marie Shellum is listed in the NPPES registry with a primary specialty of Speech-Language Pathologist in Kenmore, NY and a listed phone number of (716) 871-9883.

NPI 1255408589Kenmore, NYSpeech-Language Pathologist

Profile Overview

NPI
1255408589
Provider Type
Individual
Primary Specialty
Speech-Language Pathologist
Enumeration Date
November 30, 2006
Last Updated
July 08, 2007

Practice Location

  • 2565 Elmwood Ave
  • Kenmore, NY 14217-1939

Phone: (716) 871-9883

Mailing Address

  • 3788 Graeber Avenue
  • Crystal Beach, Ontario 010
  • CA

Specialties

  • Speech-Language Pathologist (235Z00000X)
Full Record
NPI
1255408589
Entity Type
Individual
Last Name
Shellum
First Name
Jacqueline
Middle Name
Marie
Name Prefix
Mrs.
Mailing Street Address
3788 Graeber Avenue
Mailing City
Crystal Beach
Mailing State
Ontario
Mailing ZIP Code
010
Mailing Country
CA
Mailing Phone
(905) 894-8215
Practice Street Address
2565 Elmwood Ave
Practice City
Kenmore
Practice State
NY
Practice ZIP Code
14217-1939
Practice Country
US
Practice Phone
(716) 871-9883
Enumeration Date
November 30, 2006
Last Updated
July 08, 2007
Sex
Female
Sole Proprietor
Yes
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Speech-Language Pathologist (235Z00000X)