Provider Demographics
NPI:1497167597
Name:WILFORD, YEVA (CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:YEVA
Middle Name:
Last Name:WILFORD
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:YEVA
Other - Middle Name:
Other - Last Name:SHNAYDMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CCC-SLP
Mailing Address - Street 1:950 PENINSULA CORPORATE CIR STE 1014
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33487-1385
Mailing Address - Country:US
Mailing Address - Phone:561-994-6590
Mailing Address - Fax:
Practice Address - Street 1:950 PENINSULA CORPORATE CIR STE 1014
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33487-1385
Practice Address - Country:US
Practice Address - Phone:561-994-6590
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-22
Last Update Date:2017-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL012090800Medicaid