Provider Demographics
NPI:1417233917
Name:NDAGIRE, STELLA (EDD, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:STELLA
Middle Name:
Last Name:NDAGIRE
Suffix:
Gender:F
Credentials:EDD, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3725 PRINCETON LAKES PKWY SW
Mailing Address - Street 2:APT # 9311
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30331-5532
Mailing Address - Country:US
Mailing Address - Phone:404-938-9468
Mailing Address - Fax:404-349-1272
Practice Address - Street 1:3725 PRINCETON LAKES PKWY SW
Practice Address - Street 2:APT # 9311
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30331-5532
Practice Address - Country:US
Practice Address - Phone:404-938-9468
Practice Address - Fax:404-349-1272
Is Sole Proprietor?:No
Enumeration Date:2011-10-27
Last Update Date:2011-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA3524235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist