Doctor Name: | STEPHANIE HALTER |
NPI Number: | 1104206184 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MCD CFY-SLP |
License Number: | 2015007165 |
Business Practice Address: | 1110 N Westwood Blvd Poplar Bluff, MO - 639013336 |
Business Phone Number: | 5737763627 |
Business Fax Number: | |
Mailing Address: | 1110 N Westwood Blvd, POPLAR BLUFF |
State: | MO |
Postal Code: | 639013336 |
Phone Number: | 5737763627 |
Fax Number: | |
NPI Enumeration Date: | 06/04/2015 |
NPI Last Update Date: | 06/04/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 2015007165 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MO |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |