Individual
SHELLY LEWIS WHITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, CCC-SLP
Contact information
Practice address
25615 N RANCH GATE RD, SCOTTSDALE, AZ 85255-2141
(480) 502-7726
Mailing address
1805 W EAGLE TALON TRL, PHOENIX, AZ 85085-5347
(828) 234-2211
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP8764
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
112477
—
AZ
Enumeration date
01/30/2007
Last updated
05/09/2014
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