Provider Demographics
NPI:1114198447
Name:JONES, STEPHANIE LEIGH (MS CCC-SLP)
Entity Type:Individual
Prefix:MISS
First Name:STEPHANIE
Middle Name:LEIGH
Last Name:JONES
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 TWINING ST BLDG 720
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36112-6027
Mailing Address - Country:US
Mailing Address - Phone:334-953-4415
Mailing Address - Fax:334-953-1900
Practice Address - Street 1:300 TWINING ST BLDG 720
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36112-6027
Practice Address - Country:US
Practice Address - Phone:334-953-4415
Practice Address - Fax:334-953-1900
Is Sole Proprietor?:No
Enumeration Date:2008-03-14
Last Update Date:2014-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2719235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
12130019Other(ASHA) AMERICAN SPEECH-LANGUAGE HEARING ASSOCIATION
AL2719OtherABESPA