Porter, Shelonda A

Porter, Shelonda A is an sole proprietor health care provider with primary practice located at 3085 Bentwood Dr , Waycross GA 31503-4117. She recently has only one registered license in Speech, Language and Hearing Service Providers / Speech-Language Pathologist, which is considered as her primary health care specialty. Porter, Shelonda A can be contacted via phone (912) 288-0214.

Contact Information

Primary practice address
3085 Bentwood Dr Waycross GA 31503-4117
Phone: (912) 288-0214
Fax: (912) 283-1570
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Speech, Language and Hearing Service Providers / Speech-Language Pathologist 235Z00000X SLP005147 Georgia

Profile Details

NPI number 1356414726
LBN Legal business name Porter, Shelonda A
Credentials M.ED., CCC-SLP
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 15th, 2006
Last updated Jul 9th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1356414726 NPPES
Other 12039364 ASHA CERTIFICATION
Other 1364319 ASHA CERTIFICATION
MEDICAID 10034561 ASHA CERTIFICATION
MEDICAID 305511 ASHA CERTIFICATION
Other SLP005147 ASHA CERTIFICATION

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