Provider Demographics
NPI:1285513770
Name:RALL-JOKERST, SHELBY RAE (MA)
Entity type:Individual
Prefix:
First Name:SHELBY
Middle Name:RAE
Last Name:RALL-JOKERST
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13383 STATE ROUTE B
Mailing Address - Street 2:
Mailing Address - City:STE GENEVIEVE
Mailing Address - State:MO
Mailing Address - Zip Code:63670-9112
Mailing Address - Country:US
Mailing Address - Phone:314-603-8900
Mailing Address - Fax:
Practice Address - Street 1:33415 MO-21
Practice Address - Street 2:
Practice Address - City:LESTERVILLE
Practice Address - State:MO
Practice Address - Zip Code:63654
Practice Address - Country:US
Practice Address - Phone:573-637-2201
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-28
Last Update Date:2025-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2025035171235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist