Provider Demographics
NPI:1861790800
Name:LOVINS, SHELBY N (MCD, CF-SLP)
Entity type:Individual
Prefix:MRS
First Name:SHELBY
Middle Name:N
Last Name:LOVINS
Suffix:
Gender:F
Credentials:MCD, CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 SOUTHWEST SQ
Mailing Address - Street 2:
Mailing Address - City:JONESBORO
Mailing Address - State:AR
Mailing Address - Zip Code:72401-5984
Mailing Address - Country:US
Mailing Address - Phone:870-336-0220
Mailing Address - Fax:870-336-0221
Practice Address - Street 1:300 SOUTHWEST SQ
Practice Address - Street 2:
Practice Address - City:JONESBORO
Practice Address - State:AR
Practice Address - Zip Code:72401-5984
Practice Address - Country:US
Practice Address - Phone:870-336-0220
Practice Address - Fax:870-336-0221
Is Sole Proprietor?:No
Enumeration Date:2011-02-28
Last Update Date:2011-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARSP#P8410235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR185927721Medicaid