Provider Demographics
NPI:1558902775
Name:MCBRATNEY, STEPHANIE L (SLP)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:L
Last Name:MCBRATNEY
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:JUDITH
Other - Middle Name:STEPHANIE
Other - Last Name:MCBRATNEY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:3510 E WHITEHALL DR
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65809-2135
Mailing Address - Country:US
Mailing Address - Phone:417-766-9133
Mailing Address - Fax:
Practice Address - Street 1:3510 E WHITEHALL DR
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65809-2135
Practice Address - Country:US
Practice Address - Phone:417-766-9133
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-30
Last Update Date:2023-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2002014032235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist