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
| License | State | Type | Specialty |
|---|---|---|---|
| 9413930-4102 | UT | MD | Speech-Language Pathologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
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All providers in Nephi, UT · Speech-Language Pathologist in Utah
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 7, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.