Shelby Kay Midboe
Individual provider Active NPI Speech-Language Pathologist · Missoula, MT
NPI 1497278543 · NPPES record last updated Mar 17, 2018
Key facts
- NPI
- 1497278543
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- SLP-SP-LIC-4968 (MT)
- Practice address
- 4095 South Ave W
Missoula, MT 59804-6301 - Phone
- (406) 549-9239
- NPI assigned
- Jul 20, 2017
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SLP-SP-LIC-4968 | MT | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Target Range Elementary School | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | SLP-SP-LIC-4968 | MT | Yes |
Addresses
Primary practice location
4095 South Ave W
Missoula, MT 59804-6301
Mailing address
4309 23Rd Ave
Missoula, MT 59803-1144
Phone (406) 529-5378
Other practice location 1
4718 23rd Ave Ste 500
Missoula, MT 59803-1133
Phone (406) 728-9162 ext. 2425
Other practice location 2
634 Eddy Ave
Missoula, MT 59812-1851
Phone (406) 243-2405
Other providers in Missoula, MT
- Michelle Moles LCSW Lac
- Michelle R Moles, LCSW, Lac, LLC
- Claire Ellen Michelson
- Warren A Michelson
- Melissa Sena Miculka
- Marie Middleton
- Karen Betts Mielke
- Mike Duchschere, Aprn, PLLC
- Mike Mondloch, Crna, Inc
- Cindy Nadine Mikes
All providers in Missoula, MT · Speech-Language Pathologist in Montana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 17, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.