Provider Demographics
NPI:1134433295
Name:SHEPHERD, TONI ALECIA (MAED)
Entity type:Individual
Prefix:
First Name:TONI
Middle Name:ALECIA
Last Name:SHEPHERD
Suffix:
Gender:F
Credentials:MAED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 LEGACY DR
Mailing Address - Street 2:
Mailing Address - City:BEREA
Mailing Address - State:KY
Mailing Address - Zip Code:40403-9594
Mailing Address - Country:US
Mailing Address - Phone:606-224-3400
Mailing Address - Fax:
Practice Address - Street 1:111 LEGACY DR
Practice Address - Street 2:
Practice Address - City:BEREA
Practice Address - State:KY
Practice Address - Zip Code:40403-9594
Practice Address - Country:US
Practice Address - Phone:606-224-3400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-01
Last Update Date:2010-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist