Provider Demographics
NPI:1356501282
Name:YARDLEY, DEBRA LEE (SLP)
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:LEE
Last Name:YARDLEY
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:DEBRA
Other - Middle Name:LEE
Other - Last Name:SILVERMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:SLP
Mailing Address - Street 1:2717 LYNN AVE
Mailing Address - Street 2:
Mailing Address - City:ST LOUIS PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55416-3941
Mailing Address - Country:US
Mailing Address - Phone:952-381-3434
Mailing Address - Fax:952-377-1430
Practice Address - Street 1:4330 CEDAR LAKE RD S
Practice Address - Street 2:
Practice Address - City:ST LOUIS PARK
Practice Address - State:MN
Practice Address - Zip Code:55416-3700
Practice Address - Country:US
Practice Address - Phone:952-381-3434
Practice Address - Fax:952-377-1430
Is Sole Proprietor?:No
Enumeration Date:2008-06-13
Last Update Date:2008-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN8188235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist