Doctor Name: | SHELLEY KATHERINE MAY |
NPI Number: | 1376804070 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MA, CCC-SLP |
License Number: | 22005477A |
Business Practice Address: | 501 S Murphy Ave Brazil, IN - 478348316 |
Business Phone Number: | 8124462636 |
Business Fax Number: | |
Mailing Address: | 4201 Tacoma Ave, FORT WAYNE |
State: | IN |
Postal Code: | 468072648 |
Phone Number: | 2604509690 |
Fax Number: | |
NPI Enumeration Date: | 05/30/2012 |
NPI Last Update Date: | 05/30/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 22005477A |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IN |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |