Shelly Lynn Chaudoin, M. ED., CCC-SLP
Individual provider Active NPI Speech-Language Pathologist · Pryor, OK
NPI 1962642314 · NPPES record last updated Feb 25, 2009
Key facts
- NPI
- 1962642314
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- 803 (OK)
- Practice address
- 510 S Elliott St
Suite C
Pryor, OK 74361-6421 - Phone
- (918) 825-4837
- NPI assigned
- Feb 25, 2009
- Sex
- Female
- Sole proprietor
- Yes
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
- Credentials
- Master of Education
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 803 | OK | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mayes County Speech Therapy Services P.L.L.C. | Speech-Language Pathologist | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 803 | OK | Yes |
Addresses
Primary practice location
510 S Elliott St
Suite C
Pryor, OK 74361-6421
Mailing address
5143 E 545
Locust Grove, OK 74352-1140
Phone (918) 373-3664
Other providers in Pryor, OK
- Jerry Wayne Campbell
- Kristia R Carey
- Stephanie Carr
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- Haley Mae Caveny
- Ashley Nicole Chee
- Gina Roselette Childers
- Claremore Pryor Eye Clinic P a
- Natasha K Clark
- Donna C Clifford
All providers in Pryor, OK · Speech-Language Pathologist in Oklahoma
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 25, 2009. 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.