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General NPI Number Information
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NPI Number | 1932598638
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Entity Type | Individual
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Provider Name | KEVIN L SHELDEN CCC-SLP
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Gender | Male
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Dates
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Enumeration Date | 01/19/2015
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Last Update Date | 06/21/2021
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Provider Practice Location Address
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Address Line | 200 LUTHER RD
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City | SHREWSBURY
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State | PA
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Zip | 17361-1726
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Country | US
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Telephone | 717-227-8529
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Fax |
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Provider Business Mailing Address
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Address Line | 11 YORK ST STE 304
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City | HANOVER
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State | PA
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Zip | 17331-3145
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Country | US
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Telephone | 505-730-7194
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 9265381-4102
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License Number State | UT
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Taxonomy #2
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | SL015638
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License Number State | PA
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