Provider Demographics
NPI:1508106840
Name:FLEETWOOD-SHELLEY, DARBY (MS)
Entity Type:Individual
Prefix:MS
First Name:DARBY
Middle Name:
Last Name:FLEETWOOD-SHELLEY
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:225 WHITE HORSE AVE
Mailing Address - Street 2:
Mailing Address - City:CLEMENTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08021-3916
Mailing Address - Country:US
Mailing Address - Phone:856-784-2100
Mailing Address - Fax:
Practice Address - Street 1:225 WHITE HORSE AVE
Practice Address - Street 2:
Practice Address - City:CLEMENTON
Practice Address - State:NJ
Practice Address - Zip Code:08021-3916
Practice Address - Country:US
Practice Address - Phone:856-784-2100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-02-24
Last Update Date:2013-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist