Healthcare Provider Details

I. General information

NPI: 1144559071
Provider Name (Legal Business Name): SHELLEY SINGH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/24/2009
Last Update Date: 05/15/2026
Certification Date: 05/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1010 OLD DES PERES RD
SAINT LOUIS MO
63131-1865
US

IV. Provider business mailing address

2656 HITCHCOCK DR
DURHAM NC
27705-1946
US

V. Phone/Fax

Practice location:
  • Phone: 314-729-0077
  • Fax: 314-729-0101
Mailing address:
  • Phone: 727-276-2661
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number2026020439
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: