Provider Demographics
NPI:1700392230
Name:NEWTON, SHELBY L (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:SHELBY
Middle Name:L
Last Name:NEWTON
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:817 15TH ST
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62439-2006
Mailing Address - Country:US
Mailing Address - Phone:815-531-7858
Mailing Address - Fax:
Practice Address - Street 1:1900 CEDAR ST
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:IL
Practice Address - Zip Code:62439-2156
Practice Address - Country:US
Practice Address - Phone:618-943-3992
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-12-20
Last Update Date:2017-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist