Individual
SHELLI KS CARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, CCC-A
Contact information
Practice address
1970 E JOYCE BLVD STE 2, FAYETTEVILLE, AR 72703-5135
(479) 443-6511
(479) 332-5029
Mailing address
1970 E JOYCE BLVD STE 2, FAYETTEVILLE, AR 72703-5135
(479) 443-6511
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
A#153
AR
231H00000X
Audiologist
ASHA #01115396
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
145761720
—
AR
01
—
153
STATE LICENSE NUMBER
AR
Enumeration date
02/12/2007
Last updated
05/10/2023
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