Provider Demographics
NPI:1033725098
Name:STANKOSKI, KALEN MICHELLE (MA,CF-SLP)
Entity Type:Individual
Prefix:
First Name:KALEN
Middle Name:MICHELLE
Last Name:STANKOSKI
Suffix:
Gender:F
Credentials:MA,CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2901 GUENEVERE DR
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23323-2704
Mailing Address - Country:US
Mailing Address - Phone:757-558-5347
Mailing Address - Fax:
Practice Address - Street 1:2901 GUENEVERE DR
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23323-2704
Practice Address - Country:US
Practice Address - Phone:757-558-5347
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-16
Last Update Date:2020-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2204000590235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist