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Individual

YELENA E SHEPARD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
SLP-CFY

Contact information

Practice address
13601 N LITCHFIELD RD STE 124, SURPRISE, AZ 85379-4260
(623) 322-8250
Mailing address
12920 W SIERRA VISTA DR, GLENDALE, AZ 85307-1915
(623) 910-4975

Taxonomy

Speciality
Code
Description
License number
State
2355S0801X
Speech-Language Assistant
SLPA11647
AZ
235Z00000X
Speech-Language Pathologist
Primary
TSLP11647
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
SLPA11647
ARIZONA DEPARTMENT OF HEALTH SERVICES
AZ
Enumeration date
03/15/2019
Last updated
07/06/2022
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