Provider Demographics
NPI:1265813745
Name:ANDERSON, SHELLEY LYNN (AUD)
Entity type:Individual
Prefix:DR
First Name:SHELLEY
Middle Name:LYNN
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:SHELLEY
Other - Middle Name:LYNN
Other - Last Name:WEST
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:15280 NW 79TH CT STE 200
Mailing Address - Street 2:
Mailing Address - City:MIAMI LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33016-5873
Mailing Address - Country:US
Mailing Address - Phone:305-558-3732
Mailing Address - Fax:786-907-4485
Practice Address - Street 1:57 GRANT DR STE F
Practice Address - Street 2:
Practice Address - City:PITTSBORO
Practice Address - State:NC
Practice Address - Zip Code:27312-9975
Practice Address - Country:US
Practice Address - Phone:984-974-5300
Practice Address - Fax:984-974-5305
Is Sole Proprietor?:No
Enumeration Date:2015-06-10
Last Update Date:2024-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAY1949231H00000X
NC12919231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist