Provider Demographics
NPI:1164613121
Name:STONEKING, JENNIFER DENISE (MA, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:DENISE
Last Name:STONEKING
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:910 5TH ST
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:KS
Mailing Address - Zip Code:66771-3080
Mailing Address - Country:US
Mailing Address - Phone:620-449-2316
Mailing Address - Fax:
Practice Address - Street 1:910 5TH ST
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:KS
Practice Address - Zip Code:66771-3080
Practice Address - Country:US
Practice Address - Phone:620-449-2316
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-06
Last Update Date:2007-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1580235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist