Individual
SHELBI POLVADO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
508 STOCKTRAIL AVE STE D, GILLETTE, WY 82716-3582
(307) 688-8000
Mailing address
PO BOX 3011, GILLETTE, WY 82717-3011
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SP-1071
WY
235Z00000X
Speech-Language Pathologist
SP3071
ME
Other
Enumeration date
05/18/2020
Last updated
05/18/2020
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