Provider Demographics
NPI:1023329158
Name:HALE-KURZAVA, STEPHANIE LANE (SLP)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:LANE
Last Name:HALE-KURZAVA
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 1:7703 NW BARRY RD
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64153-1731
Mailing Address - Country:US
Mailing Address - Phone:816-359-6392
Mailing Address - Fax:816-359-4059
Practice Address - Street 1:7703 NW BARRY RD
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64153-1731
Practice Address - Country:US
Practice Address - Phone:816-359-6392
Practice Address - Fax:816-359-4059
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-23
Last Update Date:2010-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2007032795235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist