Provider Demographics
NPI:1184353773
Name:DAVIS, SHELBY T (AUD)
Entity type:Individual
Prefix:
First Name:SHELBY
Middle Name:T
Last Name:DAVIS
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:302 MERCHANTS WALK STE 100
Mailing Address - Street 2:
Mailing Address - City:TUSCALOOSA
Mailing Address - State:AL
Mailing Address - Zip Code:35406-2291
Mailing Address - Country:US
Mailing Address - Phone:205-523-9300
Mailing Address - Fax:205-523-9301
Practice Address - Street 1:302 MERCHANTS WALK STE 100
Practice Address - Street 2:
Practice Address - City:TUSCALOOSA
Practice Address - State:AL
Practice Address - Zip Code:35406-2291
Practice Address - Country:US
Practice Address - Phone:205-523-9300
Practice Address - Fax:205-523-9301
Is Sole Proprietor?:No
Enumeration Date:2022-06-08
Last Update Date:2022-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1246A231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist