Provider Demographics
NPI:1578841318
Name:STABILE, RICKI (MA, CCC-SLP, TSSLD)
Entity Type:Individual
Prefix:MRS
First Name:RICKI
Middle Name:
Last Name:STABILE
Suffix:
Gender:F
Credentials:MA, CCC-SLP, TSSLD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 N NANCY PL
Mailing Address - Street 2:
Mailing Address - City:NORTH MASSAPEQUA
Mailing Address - State:NY
Mailing Address - Zip Code:11758-1912
Mailing Address - Country:US
Mailing Address - Phone:516-509-5386
Mailing Address - Fax:
Practice Address - Street 1:17937 137TH AVE
Practice Address - Street 2:
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11434-4032
Practice Address - Country:US
Practice Address - Phone:718-528-5399
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-27
Last Update Date:2022-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY021146-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist