Provider Demographics
NPI:1447037171
Name:WHITE-MILLER, SHELBY (MS, CCC/SLP)
Entity type:Individual
Prefix:
First Name:SHELBY
Middle Name:
Last Name:WHITE-MILLER
Suffix:
Gender:F
Credentials:MS, CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3401 WOODLAWN RD
Mailing Address - Street 2:
Mailing Address - City:ROCKY MOUNT
Mailing Address - State:NC
Mailing Address - Zip Code:27804-3824
Mailing Address - Country:US
Mailing Address - Phone:252-883-9271
Mailing Address - Fax:
Practice Address - Street 1:1210 EASTERN AVE
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:NC
Practice Address - Zip Code:27856-1817
Practice Address - Country:US
Practice Address - Phone:252-462-0070
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-14
Last Update Date:2023-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4740235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist