Provider Demographics
NPI:1952859704
Name:STEPHEN, FRANCES LESLIE
Entity Type:Individual
Prefix:
First Name:FRANCES
Middle Name:LESLIE
Last Name:STEPHEN
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 1:25078 SANES CREEK RD
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:IN
Mailing Address - Zip Code:47024-9681
Mailing Address - Country:US
Mailing Address - Phone:812-593-5146
Mailing Address - Fax:
Practice Address - Street 1:2216 N RILEY HWY
Practice Address - Street 2:
Practice Address - City:SHELBYVILLE
Practice Address - State:IN
Practice Address - Zip Code:46176-9311
Practice Address - Country:US
Practice Address - Phone:831-739-2337
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-21
Last Update Date:2016-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN22001731235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist