Doctor Name: | MISS STEPHANIE LYNN POOLE |
NPI Number: | 1649573106 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.S.-CCC |
License Number: | 004048 |
Business Practice Address: | 40 Dale Rd Avon, CT - 060013692 |
Business Phone Number: | 8609652103 |
Business Fax Number: | |
Mailing Address: | 7 Burbank Rd, ELLINGTON |
State: | CT |
Postal Code: | 060292804 |
Phone Number: | 4136369972 |
Fax Number: | |
NPI Enumeration Date: | 12/06/2010 |
NPI Last Update Date: | 12/06/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 004048 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CT |
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 |