Provider Demographics
NPI:1194157735
Name:SHANAGHER, COLEEN (MT-BC)
Entity type:Individual
Prefix:
First Name:COLEEN
Middle Name:
Last Name:SHANAGHER
Suffix:
Gender:F
Credentials:MT-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1079 SKY HILL RD
Mailing Address - Street 2:
Mailing Address - City:BRIDGEWATER
Mailing Address - State:NJ
Mailing Address - Zip Code:08807-1241
Mailing Address - Country:US
Mailing Address - Phone:908-752-3445
Mailing Address - Fax:
Practice Address - Street 1:1079 SKY HILL RD
Practice Address - Street 2:
Practice Address - City:BRIDGEWATER
Practice Address - State:NJ
Practice Address - Zip Code:08807-1241
Practice Address - Country:US
Practice Address - Phone:908-752-3445
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-06
Last Update Date:2013-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist