Provider Demographics
NPI:1255066734
Name:WHITE, STEPHANIE LEE (AUD)
Entity type:Individual
Prefix:DR
First Name:STEPHANIE
Middle Name:LEE
Last Name:WHITE
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:STEPHANIE
Other - Middle Name:WHITE
Other - Last Name:NAJARIAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AUD
Mailing Address - Street 1:201 DONAGHEY AVENUE UCA BOX 4985
Mailing Address - Street 2:
Mailing Address - City:CONWAY
Mailing Address - State:AR
Mailing Address - Zip Code:72035-0001
Mailing Address - Country:US
Mailing Address - Phone:501-450-5485
Mailing Address - Fax:
Practice Address - Street 1:2200 BRUCE ST
Practice Address - Street 2:
Practice Address - City:CONWAY
Practice Address - State:AR
Practice Address - Zip Code:72035-0001
Practice Address - Country:US
Practice Address - Phone:501-450-5485
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-19
Last Update Date:2022-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNA0000002032231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist