Provider Demographics
NPI:1568207553
Name:SHEPPARD, EMILY LYNN (CCC-SLP)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:LYNN
Last Name:SHEPPARD
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5152 DORSET DR
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44131-2013
Mailing Address - Country:US
Mailing Address - Phone:216-801-7152
Mailing Address - Fax:
Practice Address - Street 1:6960 S EDGERTON RD
Practice Address - Street 2:
Practice Address - City:BRECKSVILLE
Practice Address - State:OH
Practice Address - Zip Code:44141-3184
Practice Address - Country:US
Practice Address - Phone:216-801-7152
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-01
Last Update Date:2024-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSP.15835235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist