Provider Demographics
NPI:1104150432
Name:FROST, SHEKASHA (CCC-SLP)
Entity type:Individual
Prefix:
First Name:SHEKASHA
Middle Name:
Last Name:FROST
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2614 MEADOW VW APT 3
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72704-9348
Mailing Address - Country:US
Mailing Address - Phone:870-918-8632
Mailing Address - Fax:479-856-6623
Practice Address - Street 1:2603 MAIN DR STE 3
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:AR
Practice Address - Zip Code:72704-5281
Practice Address - Country:US
Practice Address - Phone:479-856-6640
Practice Address - Fax:479-856-6623
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-18
Last Update Date:2009-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR2540235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist