Provider Demographics
NPI:1285906024
Name:HIRSCH, SHANNON MEEGAN
Entity type:Individual
Prefix:MS
First Name:SHANNON
Middle Name:MEEGAN
Last Name:HIRSCH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:SHANNON
Other - Middle Name:BETH
Other - Last Name:MEEGAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:COBBLES ELEMENTARY SCHOOL 140 GEBHARDT RD.
Mailing Address - Street 2:
Mailing Address - City:PENFIELD
Mailing Address - State:NY
Mailing Address - Zip Code:14526
Mailing Address - Country:US
Mailing Address - Phone:585-249-6500
Mailing Address - Fax:585-248-2108
Practice Address - Street 1:COBBLES ELEMENTARY SCHOOL 140 GEBHARDT RD.
Practice Address - Street 2:
Practice Address - City:PENFIELD
Practice Address - State:NY
Practice Address - Zip Code:14526
Practice Address - Country:US
Practice Address - Phone:585-249-6500
Practice Address - Fax:585-248-2108
Is Sole Proprietor?:No
Enumeration Date:2012-02-08
Last Update Date:2021-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY012372-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist