Provider Demographics
NPI:1669788790
Name:AYERS, STEPHANIE (MS)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:
Last Name:AYERS
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:STEPHANIE
Other - Middle Name:
Other - Last Name:CHRISTENSEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:406 E LEE ST
Mailing Address - Street 2:
Mailing Address - City:SMITHFIELD
Mailing Address - State:NC
Mailing Address - Zip Code:27577-4440
Mailing Address - Country:US
Mailing Address - Phone:919-912-2030
Mailing Address - Fax:919-585-6822
Practice Address - Street 1:101 E MARKET ST STE 3B
Practice Address - Street 2:
Practice Address - City:SMITHFIELD
Practice Address - State:NC
Practice Address - Zip Code:27577-3981
Practice Address - Country:US
Practice Address - Phone:919-368-9375
Practice Address - Fax:919-585-6822
Is Sole Proprietor?:No
Enumeration Date:2010-08-26
Last Update Date:2021-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPE 6322235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist