Provider Demographics
NPI:1346622636
Name:MASLAND, SHELBY (CCC-SLP)
Entity Type:Individual
Prefix:MISS
First Name:SHELBY
Middle Name:
Last Name:MASLAND
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1155 LAVISTA RD NE APT 2114
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30324-3745
Mailing Address - Country:US
Mailing Address - Phone:407-421-6290
Mailing Address - Fax:
Practice Address - Street 1:1155 LAVISTA RD NE APT 2114
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30324-3745
Practice Address - Country:US
Practice Address - Phone:407-421-6290
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-23
Last Update Date:2015-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist