Provider Demographics
NPI:1093960569
Name:MCFARLAND, STACEY ELIZABETH (MA, CCC/SLP, TSHH)
Entity Type:Individual
Prefix:MRS
First Name:STACEY
Middle Name:ELIZABETH
Last Name:MCFARLAND
Suffix:
Gender:F
Credentials:MA, CCC/SLP, TSHH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 BOGART AVE
Mailing Address - Street 2:
Mailing Address - City:PORT WASHINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:11050-4005
Mailing Address - Country:US
Mailing Address - Phone:516-708-1379
Mailing Address - Fax:
Practice Address - Street 1:5 BOGART AVE
Practice Address - Street 2:
Practice Address - City:PORT WASHINGTON
Practice Address - State:NY
Practice Address - Zip Code:11050-4005
Practice Address - Country:US
Practice Address - Phone:516-708-1379
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-24
Last Update Date:2008-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY016175-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist