Provider Demographics
NPI:1336807619
Name:RHOADES, SHELBY (SLPA)
Entity Type:Individual
Prefix:
First Name:SHELBY
Middle Name:
Last Name:RHOADES
Suffix:
Gender:F
Credentials:SLPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6301 HIGHWAY 45 STE B
Mailing Address - Street 2:
Mailing Address - City:FORT SMITH
Mailing Address - State:AR
Mailing Address - Zip Code:72916-8857
Mailing Address - Country:US
Mailing Address - Phone:479-763-1412
Mailing Address - Fax:479-763-1425
Practice Address - Street 1:6301 HIGHWAY 45 STE B
Practice Address - Street 2:
Practice Address - City:FORT SMITH
Practice Address - State:AR
Practice Address - Zip Code:72916-8857
Practice Address - Country:US
Practice Address - Phone:479-763-1412
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-03
Last Update Date:2021-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant