Provider Demographics
NPI:1629605373
Name:LAMANNA, STEPHANIE MICHELE
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:MICHELE
Last Name:LAMANNA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28 FISHER DR
Mailing Address - Street 2:
Mailing Address - City:HILLSBOROUGH
Mailing Address - State:NJ
Mailing Address - Zip Code:08844-5257
Mailing Address - Country:US
Mailing Address - Phone:908-698-7635
Mailing Address - Fax:
Practice Address - Street 1:55 MADISON AVE STE 320
Practice Address - Street 2:
Practice Address - City:MORRISTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07960-7337
Practice Address - Country:US
Practice Address - Phone:973-971-4452
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-24
Last Update Date:2020-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YS00908100235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist