Doctor Name: | MRS. PENELOPE ANASTASIA STOLL |
NPI Number: | 1902156086 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | SLP |
License Number: | 319 |
Business Practice Address: | Nye Legacy, 3210 N. Clarkson St Fremont, NE - 68025 |
Business Phone Number: | 4027219300 |
Business Fax Number: | |
Mailing Address: | 12321 Nicholas St, OMAHA |
State: | NE |
Postal Code: | 681541381 |
Phone Number: | 4026307798 |
Fax Number: | |
NPI Enumeration Date: | 09/14/2012 |
NPI Last Update Date: | 09/14/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 319 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NE |
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 |