Provider Demographics
NPI:1821328311
Name:LEAL, STEPHANIE A (MA,CCC/SLP)
Entity Type:Individual
Prefix:MISS
First Name:STEPHANIE
Middle Name:A
Last Name:LEAL
Suffix:
Gender:F
Credentials:MA,CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:222 E RIDGE RD
Mailing Address - Street 2:SUITE 207
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78503-1251
Mailing Address - Country:US
Mailing Address - Phone:956-632-6426
Mailing Address - Fax:956-682-9602
Practice Address - Street 1:222 E RIDGE RD
Practice Address - Street 2:SUITE 207
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78503-1251
Practice Address - Country:US
Practice Address - Phone:956-632-6426
Practice Address - Fax:956-682-9602
Is Sole Proprietor?:No
Enumeration Date:2010-01-05
Last Update Date:2010-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX100737235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist