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General NPI Number Information
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NPI Number | 1295294585
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Entity Type | Individual
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Provider Name | YELENA E SHEPARD SLP-CFY
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Gender | Female
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Dates
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Enumeration Date | 03/15/2019
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Last Update Date | 07/06/2022
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Provider Practice Location Address
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Address Line | 13601 N LITCHFIELD RD STE 124
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City | SURPRISE
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State | AZ
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Zip | 85379-4260
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Country | US
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Telephone | 623-322-8250
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Fax |
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Provider Business Mailing Address
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Address Line | 12920 W SIERRA VISTA DR
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City | GLENDALE
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State | AZ
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Zip | 85307-1915
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Country | US
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Telephone | 623-910-4975
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2355S0801X
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Taxonomy Name | Speech-Language Assistant
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License Number | SLPA11647
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | TSLP11647
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License Number State | AZ
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