Provider Demographics
NPI:1780055426
Name:LYBRAND, SHELBY (MS CCC-SLP)
Entity type:Individual
Prefix:
First Name:SHELBY
Middle Name:
Last Name:LYBRAND
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:SHELBY
Other - Middle Name:ANN
Other - Last Name:COPELAND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1020 W HOLLAND AVE
Mailing Address - Street 2:
Mailing Address - City:WHITE HALL
Mailing Address - State:AR
Mailing Address - Zip Code:71602-9572
Mailing Address - Country:US
Mailing Address - Phone:870-692-7209
Mailing Address - Fax:
Practice Address - Street 1:1005 MICHAEL ANN DR
Practice Address - Street 2:
Practice Address - City:WHITE HALL
Practice Address - State:AR
Practice Address - Zip Code:71602-9526
Practice Address - Country:US
Practice Address - Phone:870-692-7209
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-07
Last Update Date:2024-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARSP#P8953235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist