Provider Demographics
NPI:1851277974
Name:SHAY, TIMOTHY RODNEY DAVIS
Entity type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:RODNEY DAVIS
Last Name:SHAY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:515 VERNON PL
Mailing Address - Street 2:
Mailing Address - City:FERGUS FALLS
Mailing Address - State:MN
Mailing Address - Zip Code:56537-3135
Mailing Address - Country:US
Mailing Address - Phone:218-205-7689
Mailing Address - Fax:
Practice Address - Street 1:119 FRIBERG AVE
Practice Address - Street 2:
Practice Address - City:FERGUS FALLS
Practice Address - State:MN
Practice Address - Zip Code:56537-2306
Practice Address - Country:US
Practice Address - Phone:218-332-2018
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-13
Last Update Date:2025-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical