Provider Demographics
NPI:1245401918
Name:SHELL, CASEY ENGEBRETSEN (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:CASEY
Middle Name:ENGEBRETSEN
Last Name:SHELL
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:163 JOE PHILLIPS RD
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:AL
Mailing Address - Zip Code:35758-9769
Mailing Address - Country:US
Mailing Address - Phone:562-274-1885
Mailing Address - Fax:888-972-4982
Practice Address - Street 1:375 MOUNT ZION RD
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:AL
Practice Address - Zip Code:35757-7725
Practice Address - Country:US
Practice Address - Phone:256-274-1885
Practice Address - Fax:888-972-4982
Is Sole Proprietor?:No
Enumeration Date:2008-03-20
Last Update Date:2022-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2708235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist