Provider Demographics
NPI:1275688327
Name:HALL, SHELBY
Entity Type:Individual
Prefix:MS
First Name:SHELBY
Middle Name:
Last Name:HALL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2002 MCFARLAND BLVD E
Mailing Address - Street 2:SUITE 209
Mailing Address - City:TUSCALOOSA
Mailing Address - State:AL
Mailing Address - Zip Code:35404-5805
Mailing Address - Country:US
Mailing Address - Phone:205-752-0476
Mailing Address - Fax:205-752-8122
Practice Address - Street 1:2002 MCFARLAND BLVD E
Practice Address - Street 2:SUITE 209
Practice Address - City:TUSCALOOSA
Practice Address - State:AL
Practice Address - Zip Code:35404-5805
Practice Address - Country:US
Practice Address - Phone:205-752-0476
Practice Address - Fax:205-752-8122
Is Sole Proprietor?:No
Enumeration Date:2007-01-25
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2078235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist