Provider Demographics
NPI:1093866022
Name:RAMEY, STACIE I (CCC SLP)
Entity Type:Individual
Prefix:MRS
First Name:STACIE
Middle Name:I
Last Name:RAMEY
Suffix:
Gender:F
Credentials:CCC SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13984 COLUMBINE AVE
Mailing Address - Street 2:
Mailing Address - City:WELLINGTON
Mailing Address - State:FL
Mailing Address - Zip Code:33414-8108
Mailing Address - Country:US
Mailing Address - Phone:561-383-6497
Mailing Address - Fax:561-383-7067
Practice Address - Street 1:12773 W FOREST HILL BLVD
Practice Address - Street 2:SUITE 214
Practice Address - City:WELLINGTON
Practice Address - State:FL
Practice Address - Zip Code:33414-4767
Practice Address - Country:US
Practice Address - Phone:561-512-3551
Practice Address - Fax:561-383-7067
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-16
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA 0905235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist