Provider Demographics
NPI:1801350467
Name:CARTER, SHELBY KATHLEEN (MS, CCC-SLP)
Entity type:Individual
Prefix:MISS
First Name:SHELBY
Middle Name:KATHLEEN
Last Name:CARTER
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 1:348 CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:LEBANON JUNCTION
Mailing Address - State:KY
Mailing Address - Zip Code:40150-8314
Mailing Address - Country:US
Mailing Address - Phone:502-264-3948
Mailing Address - Fax:
Practice Address - Street 1:348 CHURCH ST
Practice Address - Street 2:
Practice Address - City:LEBANON JUNCTION
Practice Address - State:KY
Practice Address - Zip Code:40150-8314
Practice Address - Country:US
Practice Address - Phone:502-264-3948
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-29
Last Update Date:2020-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY260508235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist