Provider Demographics
NPI:1922746205
Name:LEMON, SHAYLA L (MS CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:SHAYLA
Middle Name:L
Last Name:LEMON
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:SHAYLA
Other - Middle Name:L
Other - Last Name:PODLENA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS CCC-SLP
Mailing Address - Street 1:2148 AWAPUHI ST
Mailing Address - Street 2:
Mailing Address - City:HILO
Mailing Address - State:HI
Mailing Address - Zip Code:96720-5290
Mailing Address - Country:US
Mailing Address - Phone:808-365-8128
Mailing Address - Fax:808-961-6383
Practice Address - Street 1:2148 AWAPUHI ST
Practice Address - Street 2:
Practice Address - City:HILO
Practice Address - State:HI
Practice Address - Zip Code:96720-5290
Practice Address - Country:US
Practice Address - Phone:808-365-8128
Practice Address - Fax:808-961-6383
Is Sole Proprietor?:No
Enumeration Date:2022-05-25
Last Update Date:2024-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HICF235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI1891375028Medicaid
HI1306468806OtherPRIVATE PAY