Provider Demographics
NPI:1497045660
Name:YABLOK, SHIRA H (MS, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:SHIRA
Middle Name:H
Last Name:YABLOK
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8018 STANFORD AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63130-3614
Mailing Address - Country:US
Mailing Address - Phone:314-256-9043
Mailing Address - Fax:
Practice Address - Street 1:8018 STANFORD AVE
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63130-3614
Practice Address - Country:US
Practice Address - Phone:314-256-9043
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-08
Last Update Date:2011-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2008013274235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist