Provider Demographics
NPI:1396050183
Name:EINSIEDLER, STEPHANIE (SLP)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:
Last Name:EINSIEDLER
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 1:148 SEA RD
Mailing Address - Street 2:
Mailing Address - City:KENNEBUNK
Mailing Address - State:ME
Mailing Address - Zip Code:04043-7319
Mailing Address - Country:US
Mailing Address - Phone:207-985-3631
Mailing Address - Fax:
Practice Address - Street 1:148 SEA RD
Practice Address - Street 2:
Practice Address - City:KENNEBUNK
Practice Address - State:ME
Practice Address - Zip Code:04043-7319
Practice Address - Country:US
Practice Address - Phone:207-985-3631
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-17
Last Update Date:2010-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MESP297235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist