Provider Demographics
NPI:1679832786
Name:MAY, SHELBY TANNER (SLPA)
Entity Type:Individual
Prefix:
First Name:SHELBY
Middle Name:TANNER
Last Name:MAY
Suffix:
Gender:F
Credentials:SLPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 E BASELINE RD STE B-6
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85283-1266
Mailing Address - Country:US
Mailing Address - Phone:480-839-6000
Mailing Address - Fax:480-839-6363
Practice Address - Street 1:600 E BASELINE RD STE B-6
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85283-1266
Practice Address - Country:US
Practice Address - Phone:480-839-6000
Practice Address - Fax:480-839-6363
Is Sole Proprietor?:No
Enumeration Date:2012-05-09
Last Update Date:2012-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZSLPA76392355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant