Provider Demographics
NPI:1467829416
Name:STOVERINK, CHELSEY (SLP)
Entity Type:Individual
Prefix:
First Name:CHELSEY
Middle Name:
Last Name:STOVERINK
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:RR 2 BOX 850
Mailing Address - Street 2:
Mailing Address - City:MARBLE HILL
Mailing Address - State:MO
Mailing Address - Zip Code:63764-9529
Mailing Address - Country:US
Mailing Address - Phone:573-208-8719
Mailing Address - Fax:
Practice Address - Street 1:RR 2 BOX 850
Practice Address - Street 2:
Practice Address - City:MARBLE HILL
Practice Address - State:MO
Practice Address - Zip Code:63764-9529
Practice Address - Country:US
Practice Address - Phone:573-208-8719
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-25
Last Update Date:2015-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2015000140235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist