Provider Demographics
NPI:1518362367
Name:SHEPHERD, SABRINA PANZA (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:SABRINA
Middle Name:PANZA
Last Name:SHEPHERD
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7203 N CHARLES ST
Mailing Address - Street 2:
Mailing Address - City:LUTHERVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21093-5430
Mailing Address - Country:US
Mailing Address - Phone:202-503-5153
Mailing Address - Fax:
Practice Address - Street 1:8600 LA SALLE RD STE 335
Practice Address - Street 2:
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21286-2009
Practice Address - Country:US
Practice Address - Phone:410-823-0880
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-22
Last Update Date:2020-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD07121235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist