Provider Demographics
NPI:1659847499
Name:STORY, SHELBY NICOLE
Entity Type:Individual
Prefix:
First Name:SHELBY
Middle Name:NICOLE
Last Name:STORY
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:PO BOX 29
Mailing Address - Street 2:
Mailing Address - City:ALVORD
Mailing Address - State:TX
Mailing Address - Zip Code:76225-0029
Mailing Address - Country:US
Mailing Address - Phone:940-577-4550
Mailing Address - Fax:940-427-2315
Practice Address - Street 1:982 BLUFFS AVE
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:TX
Practice Address - Zip Code:76230
Practice Address - Country:US
Practice Address - Phone:940-577-4550
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-19
Last Update Date:2018-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant