Provider Demographics
NPI:1184071847
Name:STEPHENS, STEPHANY LYNN (MA, CCC-SLP)
Entity type:Individual
Prefix:
First Name:STEPHANY
Middle Name:LYNN
Last Name:STEPHENS
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 1:1880 KING ST
Mailing Address - Street 2:
Mailing Address - City:OWOSSO
Mailing Address - State:MI
Mailing Address - Zip Code:48867-9516
Mailing Address - Country:US
Mailing Address - Phone:517-243-7928
Mailing Address - Fax:
Practice Address - Street 1:1159 E M 21 STE A
Practice Address - Street 2:
Practice Address - City:OWOSSO
Practice Address - State:MI
Practice Address - Zip Code:48867-9037
Practice Address - Country:US
Practice Address - Phone:989-607-0070
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-23
Last Update Date:2023-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist