Provider Demographics
NPI:1750716379
Name:NEGLEY, SHELLY (MS CCC-SLP)
Entity type:Individual
Prefix:MS
First Name:SHELLY
Middle Name:
Last Name:NEGLEY
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:415 FAIR LN
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:22603-4503
Mailing Address - Country:US
Mailing Address - Phone:540-532-0268
Mailing Address - Fax:
Practice Address - Street 1:250 FIRST WOODS DR
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22603-4899
Practice Address - Country:US
Practice Address - Phone:540-678-1868
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-13
Last Update Date:2019-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVSLP-1424235Z00000X
VA2202006547235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist