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Individual

MISS SHELBY MICHELLE PETERSEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
SLP-A

Contact information

Practice address
10310 W MARKHAM ST STE 205, LITTLE ROCK, AR 72205-1579
(501) 406-7910
Mailing address
104 CALAIS CV, LITTLE ROCK, AR 72223-9575
(501) 940-2335

Taxonomy

Speciality
Code
Description
License number
State
2355S0801X
Speech-Language Assistant
Primary
18-007
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
18-007
ARKANSAS BOARD OF EXAMINERS IN SPEECH PATHOLOGY AND AUDIOLOGY
AR
Enumeration date
11/01/2017
Last updated
03/17/2018
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