Provider Demographics
NPI:1407693351
Name:NOBLE, SHELLEY K (SLP)
Entity type:Individual
Prefix:MRS
First Name:SHELLEY
Middle Name:K
Last Name:NOBLE
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1220 W 2ND ST
Mailing Address - Street 2:
Mailing Address - City:BEAVER
Mailing Address - State:OK
Mailing Address - Zip Code:73932-3423
Mailing Address - Country:US
Mailing Address - Phone:580-527-1650
Mailing Address - Fax:
Practice Address - Street 1:LAVERNE PUBLIC SCHOOL
Practice Address - Street 2:605 JANE JAYROE BLVD
Practice Address - City:LAVERNE
Practice Address - State:OK
Practice Address - Zip Code:73848
Practice Address - Country:US
Practice Address - Phone:580-921-3362
Practice Address - Fax:580-921-3636
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-09
Last Update Date:2024-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK1075235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist