Provider Demographics
NPI:1265705040
Name:LIVORSI, STEPHANIE (SPEECH PATHOLOGIST)
Entity type:Individual
Prefix:MRS
First Name:STEPHANIE
Middle Name:
Last Name:LIVORSI
Suffix:
Gender:F
Credentials:SPEECH PATHOLOGIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1015 TARRAGON CT
Mailing Address - Street 2:
Mailing Address - City:MORGANVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07751-1804
Mailing Address - Country:US
Mailing Address - Phone:732-970-0548
Mailing Address - Fax:
Practice Address - Street 1:1015 TARRAGON CT
Practice Address - Street 2:
Practice Address - City:MORGANVILLE
Practice Address - State:NJ
Practice Address - Zip Code:07751-1804
Practice Address - Country:US
Practice Address - Phone:732-970-0548
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-09
Last Update Date:2012-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YS00445900235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist