| Doctor Name: | MICAEL DEAN-STANTON |
| NPI Number: | 1174780662 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | SLP |
| License Number: | 1654 |
| Business Practice Address: | 141 Market Pl Suite 203 Fairview Heights, IL - 622082034 |
| Business Phone Number: | 6183984118 |
| Business Fax Number: | 8478819640 |
| Mailing Address: | 141 Market Pl, Suite 203 FAIRVIEW HEIGHTS |
| State: | IL |
| Postal Code: | 622082034 |
| Phone Number: | 6183984118 |
| Fax Number: | 8478819640 |
| NPI Enumeration Date: | 05/21/2008 |
| NPI Last Update Date: | 05/21/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | 1654 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | KS |
| 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 |