MISS SHELBY MICHELLE PETERSEN (NPI# 1285146142) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1285146142 |
Entity Type | Individual |
Full Name | MISS SHELBY MICHELLE PETERSEN |
Credential | SLP-A |
Practice Address |
10310 W Markham St Ste 205 Little Rock AR 72205-1579 |
Mailing Address |
104 Calais Cv Little Rock AR 72223-9575 |
Practice Telephone | 5014067910 |
Mailing Telephone | 5019402335 |
Enumeration Date | 2017-11-01 |
Last Update Date | 2018-03-17 |
Gender Code | F |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 2355S0801X |
Specialist/Technologist Specialization: Speech-Language Assistant |
18-007 | AR | Speech, Language and Hearing Service Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
AR | ARKANSAS BOARD OF EXAMINERS IN SPEECH PATHOLOGY AND AUDIOLOGY | 18-007 | 01 |
Address | Telephone Number | Fax Number |
---|---|---|
104 Calais Cv, Little Rock, AR 722239575 | 5019402335 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1205329992 | Shelby Petersen | Technician/Technologist | 32100 Telegraph Rd Ste 205, Bingham Farms, MI 48025-2454 | 2018-06-07 |
Street Address |
10310 W MARKHAM ST STE 205 |
City | LITTLE ROCK |
State | AR |
Zip Code | 72205-1579 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1760092266 | Maggie Mcmorran | Speech-Language Pathologist | 10310 W Markham St Ste 205, Little Rock, AR 72205-1579 | 2020-08-09 |
1114552569 | Madisyn Stewart | Occupational Therapy Assistant | 10310 W Markham St Ste 205, Little Rock, AR 72205-1579 | 2020-03-05 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1932719465 | Darleisha Renee Stigall | Behavior Technician | 1210 Aldersdate Rd, Little Rock, AR 72205 | 2020-08-10 |
1316563638 | Unknown Amisha | Student in an Organized Health Care Education/Training Program | 4301 West Markham St, Slot #634, University of Arkansas, Little Rock, AR 72205 | 2020-06-23 |
1225667272 | Ann-marie Frances Hayre | Student in an Organized Health Care Education/Training Program | 4310 West Markham, Slot 589, Little Rock, AR 72205 | 2020-04-02 |
1952930075 | Alexandria Leigh Smith | Student in an Organized Health Care Education/Training Program | 4301 West Markham St, Slot 531, Little Rock, AR 72205 | 2020-04-02 |
1093353922 | Phil Fagala | Pharmacist | 614 North Beechwood, Little Rock, AR 72205 | 2019-12-10 |
1295391688 | Home To Community Living, Inc | Physical Therapist | 10201 W Markham Street Pulaski, Little Rock, AR 72205 | 2019-05-12 |
1669933693 | Sandy Louise Webb | Student in an Organized Health Care Education/Training Program | 4301 West Markham, Slot 530, Little Rock, AR 72205 | 2019-03-31 |
1457812828 | Vincent Battafarano | Student in an Organized Health Care Education/Training Program | 4301 West Markham, Slot 602, Little Rock, AR 72205 | 2019-03-28 |
1063978922 | Franks Pediatric Occupational Therapy LLC | Occupational Therapist | 5516 C St, Little Rock, AR 72205 | 2019-02-15 |
1497210199 | Integrative Counseling Center LLC | Counselor | 10515 W Markham St Ste D3, Little Rock, AR 72205 | 2019-02-06 |
Find all providers in zip 72205 |
Taxonomy Code | 2355S0801X |
Grouping | Speech, Language and Hearing Service Providers |
Classification | Specialist/Technologist |
Specialization | Speech-Language Assistant |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1164963047 | Terrie Ann Nash | Specialist/Technologist | 16 Eagle Nest Ct, Little Rock, AR 72210-8793 | 2017-03-13 |
1932657020 | Anna Lindsey | Specialist/Technologist | 7020 W Markham St, Little Rock, AR 72205-2777 | 2016-09-16 |
1962866731 | Juanita Yuille | Specialist/Technologist | 1122 S Cross St, Little Rock, AR 72202-4738 | 2016-04-07 |
1255537452 | Yolanda Michelle Rawls | Specialist/Technologist | 7912 Mabelvale Pike, Little Rock, AR 72209-3353 | 2007-06-25 |
1932766516 | Shannon Dale Toye | Specialist/Technologist | 1410 W Daisy L Gatson Bates Dr, Little Rock, AR 72202-5434 | 2019-05-20 |
1851835839 | Gracen Kate Miller | Specialist/Technologist | 1900 Aldersgate Rd, Little Rock, AR 72205-6620 | 2016-12-12 |
1619337235 | Jill Mills | Specialist/Technologist | 708 E Dixon Rd, Little Rock, AR 72206-4114 | 2016-02-24 |
1477912376 | Rebecca Hupp | Specialist/Technologist | 708 E Dixon Rd, Little Rock, AR 72206-4114 | 2016-02-19 |
1942669411 | Sarah Baxter | Specialist/Technologist | 708 E Dixon Rd, Little Rock, AR 72206-4114 | 2016-02-12 |
1104299080 | Nicole Bailey | Specialist/Technologist | 10515 W Markham St, E-1, Little Rock, AR 72205-2297 | 2015-11-02 |
Find all providers in LITTLE ROCK |
City | LITTLE ROCK |
Zip Code | 72205 |
Please comment or provide details below to improve the information on MISS SHELBY MICHELLE PETERSEN.
Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.