Provider Demographics
NPI:1568891133
Name:KRIEBEL, STEPHANIE (MS CCC-SLP)
Entity Type:Individual
Prefix:MISS
First Name:STEPHANIE
Middle Name:
Last Name:KRIEBEL
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:STEPHANIE
Other - Middle Name:
Other - Last Name:LAPORTE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:52409 CREEK LN
Mailing Address - Street 2:
Mailing Address - City:CHESTERFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48047-4544
Mailing Address - Country:US
Mailing Address - Phone:586-251-0840
Mailing Address - Fax:
Practice Address - Street 1:52409 CREEK LN
Practice Address - Street 2:
Practice Address - City:CHESTERFIELD
Practice Address - State:MI
Practice Address - Zip Code:48047
Practice Address - Country:US
Practice Address - Phone:586-251-0840
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-05
Last Update Date:2019-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI7101004740235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist