Provider Demographics
NPI:1518189638
Name:SCHMELZLE, SHELLY S (MA, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:SHELLY
Middle Name:S
Last Name:SCHMELZLE
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22609 W 50TH ST
Mailing Address - Street 2:
Mailing Address - City:SHAWNEE
Mailing Address - State:KS
Mailing Address - Zip Code:66226-3842
Mailing Address - Country:US
Mailing Address - Phone:913-422-3998
Mailing Address - Fax:
Practice Address - Street 1:22609 W 50TH ST
Practice Address - Street 2:
Practice Address - City:SHAWNEE
Practice Address - State:KS
Practice Address - Zip Code:66226-3842
Practice Address - Country:US
Practice Address - Phone:913-422-3998
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS633235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist