Provider Demographics
NPI:1609518588
Name:TRULUCK, SHELBY E
Entity Type:Individual
Prefix:
First Name:SHELBY
Middle Name:E
Last Name:TRULUCK
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 1:1600 HAMPTON LN
Mailing Address - Street 2:
Mailing Address - City:SAFETY HARBOR
Mailing Address - State:FL
Mailing Address - Zip Code:34695-5236
Mailing Address - Country:US
Mailing Address - Phone:727-688-0393
Mailing Address - Fax:
Practice Address - Street 1:2595 TAMPA RD STE Q
Practice Address - Street 2:
Practice Address - City:PALM HARBOR
Practice Address - State:FL
Practice Address - Zip Code:34684-3132
Practice Address - Country:US
Practice Address - Phone:727-804-4836
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-11
Last Update Date:2022-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist