Provider Demographics
NPI:1205427879
Name:SMITH, SHELBY SELEENA (CF-SLP)
Entity type:Individual
Prefix:
First Name:SHELBY
Middle Name:SELEENA
Last Name:SMITH
Suffix:
Gender:F
Credentials:CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5342 REMINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:FIRESTONE
Mailing Address - State:CO
Mailing Address - Zip Code:80504-3544
Mailing Address - Country:US
Mailing Address - Phone:720-219-2688
Mailing Address - Fax:
Practice Address - Street 1:5342 REMINGTON AVE
Practice Address - Street 2:
Practice Address - City:FIRESTONE
Practice Address - State:CO
Practice Address - Zip Code:80504-3544
Practice Address - Country:US
Practice Address - Phone:720-219-2688
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-27
Last Update Date:2021-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist