Individual
MRS. SHELBY ANN SUDHOLT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS CCC SLP
Contact information
Practice address
1610 E. SUNSHINE ST., SPRINGFIELD, MO 65804
(417) 742-0930
(417) 742-2586
Mailing address
1610 E. SUNSHINE ST., SPRINGFIELD, MO 65804
(417) 742-0930
(417) 742-2586
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2005025934
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
465463404
—
MO
Enumeration date
03/20/2007
Last updated
09/09/2020
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