Individual
MRS. KELLEY SHIRLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
4778 OVERTON RD, BIRMINGHAM, AL 35210-3803
(205) 957-0294
(205) 957-0298
Mailing address
4778 OVERTON RD, BIRMINGHAM, AL 35210-3803
(205) 957-0294
(205) 957-0298
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
6288548
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
515-35381
BCBS PROVIDER NUMBER
AL
Enumeration date
03/28/2007
Last updated
07/08/2007
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