MEDICARE: MS. SHELBY ZANKS M.S. 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	2202006270	VA

General Provider Information

NPI Number	:	1497042709
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. SHELBY ZANKS M.S. CCC-SLP

Provider Business Mailing Address
First Line	:	12 WHITEHOUSE DR
Second Line	:
City	:	POQUOSON
State	:	VA
Zip	:	23662-1614
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4102 E PARHAM RD STE A
Second Line	:
City	:	HENRICO
State	:	VA
Zip	:	23228-2743
Country	:	US
Telephone Number	:	804-672-8588
Fax Number	:	804-672-8587

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

Provider Enumeration Date	:	07/07/2011
Last Update Date	:	07/07/2011

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Directions to “ MS. SHELBY ZANKS M.S. CCC-SLP” Practice Location

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