Shelly Lebaron

Individual provider Active NPI Speech-Language Pathologist · Nephi, UT

NPI 1578036067 · NPPES record last updated Jan 7, 2019

Key facts

NPI
1578036067
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
9413930-4102 (UT)
Practice address
1324 N 150 E
Nephi, UT 84648-4600
Phone
(435) 851-4011
NPI assigned
Jan 7, 2019
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
9413930-4102UTMDSpeech-Language Pathologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 9413930-4102 UT Yes

Addresses

Primary practice location

1324 N 150 E
Nephi, UT 84648-4600

Mailing address

1324 N 150 E
Nephi, UT 84648-4600
Phone (435) 851-4011

Other providers in Nephi, UT

All providers in Nephi, UT · Speech-Language Pathologist in Utah

Sources for this page

Verify at the official NPI Registry.