Provider Demographics
NPI:1275388175
Name:STAHLY, EBBY CHARLENE (MS)
Entity Type:Individual
Prefix:MS
First Name:EBBY
Middle Name:CHARLENE
Last Name:STAHLY
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2720 CROW VALLEY TRL
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75023-6310
Mailing Address - Country:US
Mailing Address - Phone:214-552-2456
Mailing Address - Fax:
Practice Address - Street 1:2720 CROW VALLEY TRL
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75023-6310
Practice Address - Country:US
Practice Address - Phone:214-552-2456
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-23
Last Update Date:2024-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX17317235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist