Doctor Name: | STEPHANIE LYNN PHAM |
NPI Number: | 1336451236 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MS CCC-SLP |
License Number: | 12011612 |
Business Practice Address: | 119 Bastille Dr Pagosa Springs, CO - 811479388 |
Business Phone Number: | 9707314330 |
Business Fax Number: | 9707314046 |
Mailing Address: | Po Box 2453, PAGOSA SPRINGS |
State: | CO |
Postal Code: | 811472453 |
Phone Number: | 9707313610 |
Fax Number: | |
NPI Enumeration Date: | 07/08/2010 |
NPI Last Update Date: | 07/08/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 12011612 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
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 |