Individual
SHELLY LEBARON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1324 N 150 E, NEPHI, UT 84648-4600
(435) 851-4011
Mailing address
1324 N 150 E, NEPHI, UT 84648-4600
(435) 851-4011
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
9413930-4102
UT
Other
Enumeration date
01/07/2019
Last updated
01/07/2019
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