Doctor Name: | STACEY NICOLE NEWMAN |
NPI Number: | 1902057300 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MS CCC-SLP |
License Number: | 2008029382 |
Business Practice Address: | 610 Nw Yennie St Apt 204 Grain Valley, MO - 640299492 |
Business Phone Number: | 8168302742 |
Business Fax Number: | |
Mailing Address: | 610 Nw Yennie St Apt 204, GRAIN VALLEY |
State: | MO |
Postal Code: | 640299492 |
Phone Number: | 8168302742 |
Fax Number: | |
NPI Enumeration Date: | 10/02/2008 |
NPI Last Update Date: | 07/26/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 2008029382 |
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 |