Provider Demographics
NPI:1013494657
Name:BROWN, STEFANIE (MS CCC-SLP)
Entity Type:Individual
Prefix:
First Name:STEFANIE
Middle Name:
Last Name:BROWN
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:STEFANIE
Other - Middle Name:
Other - Last Name:SWANK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 62
Mailing Address - Street 2:
Mailing Address - City:WYCOMBE
Mailing Address - State:PA
Mailing Address - Zip Code:18980-0062
Mailing Address - Country:US
Mailing Address - Phone:215-534-5002
Mailing Address - Fax:
Practice Address - Street 1:705 N SHADY RETREAT RD
Practice Address - Street 2:
Practice Address - City:DOYLESTOWN
Practice Address - State:PA
Practice Address - Zip Code:18901-2507
Practice Address - Country:US
Practice Address - Phone:800-770-4822
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-26
Last Update Date:2018-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL013363235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist