Provider Demographics
NPI:1376435602
Name:BAGLEY, SHELBY (CCC-SLP)
Entity type:Individual
Prefix:
First Name:SHELBY
Middle Name:
Last Name:BAGLEY
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5250 VILLA VERDE DR APT U6
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89523-1571
Mailing Address - Country:US
Mailing Address - Phone:970-534-5089
Mailing Address - Fax:970-534-5089
Practice Address - Street 1:2875 SAINT ROSE PKWY
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89052-4838
Practice Address - Country:US
Practice Address - Phone:800-966-0535
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-21
Last Update Date:2025-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist