Provider Demographics
NPI:1356094890
Name:BOLLMAN, SHAYLA LYNN (MA, CF-SLP)
Entity Type:Individual
Prefix:MRS
First Name:SHAYLA
Middle Name:LYNN
Last Name:BOLLMAN
Suffix:
Gender:F
Credentials:MA, CF-SLP
Other - Prefix:MS
Other - First Name:SHAYLA
Other - Middle Name:LYNN
Other - Last Name:EVANS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:890 OAK RIDGE CHURCH RD
Mailing Address - Street 2:
Mailing Address - City:CORBIN
Mailing Address - State:KY
Mailing Address - Zip Code:40701-5241
Mailing Address - Country:US
Mailing Address - Phone:606-260-3542
Mailing Address - Fax:
Practice Address - Street 1:181 OLD WHITLEY RD
Practice Address - Street 2:
Practice Address - City:LONDON
Practice Address - State:KY
Practice Address - Zip Code:40744-8211
Practice Address - Country:US
Practice Address - Phone:606-330-0223
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-03
Last Update Date:2023-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YS01223200235Z00000X
KY259992235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist