Provider Demographics
NPI:1700163961
Name:SMITH, STEPHANIE A (SLPA)
Entity type:Individual
Prefix:MS
First Name:STEPHANIE
Middle Name:A
Last Name:SMITH
Suffix:
Gender:F
Credentials:SLPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 W CALLE LA BOLITA
Mailing Address - Street 2:
Mailing Address - City:SAHUARITA
Mailing Address - State:AZ
Mailing Address - Zip Code:85629-8663
Mailing Address - Country:US
Mailing Address - Phone:520-443-1109
Mailing Address - Fax:
Practice Address - Street 1:5001 N SHANNON RD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85705-1048
Practice Address - Country:US
Practice Address - Phone:520-696-8450
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-15
Last Update Date:2025-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZSLPA74492355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant