Provider Demographics
NPI:1073769527
Name:GALLOWAY, STEPHANIE LYNNE (AUD)
Entity Type:Individual
Prefix:DR
First Name:STEPHANIE
Middle Name:LYNNE
Last Name:GALLOWAY
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7629 PURFOY RD
Mailing Address - Street 2:SUITE 109
Mailing Address - City:FUQUAY-VARINA
Mailing Address - State:NC
Mailing Address - Zip Code:27526-9550
Mailing Address - Country:US
Mailing Address - Phone:919-851-3800
Mailing Address - Fax:919-851-3803
Practice Address - Street 1:7629 PURFOY ROAD
Practice Address - Street 2:SUITE 109
Practice Address - City:FUQUAY-VARINA
Practice Address - State:NC
Practice Address - Zip Code:27526-9550
Practice Address - Country:US
Practice Address - Phone:919-762-0358
Practice Address - Fax:919-762-0359
Is Sole Proprietor?:No
Enumeration Date:2008-08-15
Last Update Date:2015-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9908231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCD562Medicare UPIN