MEDICARE: SHELLY ANNA HOWARD MS.CCC-SLP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	19373	TX

General Provider Information

NPI Number	:	1053306696
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHELLY ANNA HOWARD MS.CCC-SLP

Provider Business Mailing Address
First Line	:	12700 HILLCREST RD
Second Line	:	SUITE 207
City	:	DALLAS
State	:	TX
Zip	:	75230-2033
Country	:	US
Telephone Number	:	972-387-2824
Fax Number	:	972-387-9097

Provider Business Practice Location Address
First Line	:	12700 HILLCREST RD
Second Line	:	SUITE 207
City	:	DALLAS
State	:	TX
Zip	:	75230-2033
Country	:	US
Telephone Number	:	972-387-2824
Fax Number	:	972-387-9097

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/20/2005
Last Update Date	:	01/30/2019

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