Provider Demographics
NPI:1700495199
Name:STRAYER, SHELBY (MA, CFY-SLP)
Entity Type:Individual
Prefix:
First Name:SHELBY
Middle Name:
Last Name:STRAYER
Suffix:
Gender:F
Credentials:MA, CFY-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5942 SAN RENO DR
Mailing Address - Street 2:
Mailing Address - City:SYLVANIA
Mailing Address - State:OH
Mailing Address - Zip Code:43560-1130
Mailing Address - Country:US
Mailing Address - Phone:419-906-5799
Mailing Address - Fax:
Practice Address - Street 1:600 LEMOYNE RD
Practice Address - Street 2:
Practice Address - City:NORTHWOOD
Practice Address - State:OH
Practice Address - Zip Code:43619-1812
Practice Address - Country:US
Practice Address - Phone:419-691-3888
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-30
Last Update Date:2020-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCOND.20201384-SP235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist