Provider Demographics
NPI:1750781738
Name:ADAM, STACEY ELIZABETH (MSCF-SLP)
Entity type:Individual
Prefix:
First Name:STACEY
Middle Name:ELIZABETH
Last Name:ADAM
Suffix:
Gender:F
Credentials:MSCF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 SKYLINE DR
Mailing Address - Street 2:
Mailing Address - City:SHOEMAKERSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19555-9453
Mailing Address - Country:US
Mailing Address - Phone:484-332-6203
Mailing Address - Fax:
Practice Address - Street 1:250 SKYLINE DR
Practice Address - Street 2:
Practice Address - City:SHOEMAKERSVILLE
Practice Address - State:PA
Practice Address - Zip Code:19555-9453
Practice Address - Country:US
Practice Address - Phone:484-332-6203
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-27
Last Update Date:2014-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist