Provider Demographics
NPI:1386232445
Name:JEPSEN, RILEY ANN SCHREDER (MA, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:RILEY
Middle Name:ANN SCHREDER
Last Name:JEPSEN
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:RILEY
Other - Middle Name:ANN
Other - Last Name:SCHREDER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA CCC-SLP
Mailing Address - Street 1:14407 AURORA AVE
Mailing Address - Street 2:
Mailing Address - City:URBANDALE
Mailing Address - State:IA
Mailing Address - Zip Code:50323-2689
Mailing Address - Country:US
Mailing Address - Phone:319-213-0305
Mailing Address - Fax:
Practice Address - Street 1:14407 AURORA AVE
Practice Address - Street 2:
Practice Address - City:URBANDALE
Practice Address - State:IA
Practice Address - Zip Code:50323-2689
Practice Address - Country:US
Practice Address - Phone:319-213-0305
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-05
Last Update Date:2021-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA093449235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty