Provider Demographics
NPI:1851672893
Name:BUCHANAN, STEFANIE FERRARO (SLP)
Entity Type:Individual
Prefix:
First Name:STEFANIE
Middle Name:FERRARO
Last Name:BUCHANAN
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2633 NE 33RD ST
Mailing Address - Street 2:
Mailing Address - City:FT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33306-1515
Mailing Address - Country:US
Mailing Address - Phone:954-670-4575
Mailing Address - Fax:
Practice Address - Street 1:2633 NE 33RD ST
Practice Address - Street 2:
Practice Address - City:FT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33306-1515
Practice Address - Country:US
Practice Address - Phone:954-670-4575
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-05
Last Update Date:2011-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA9535235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist