Provider Demographics
NPI:1770618159
Name:STEMKE, STACEY FLOTTE (MCDCCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:STACEY
Middle Name:FLOTTE
Last Name:STEMKE
Suffix:
Gender:F
Credentials:MCDCCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7005 WILTY ST
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70003-3121
Mailing Address - Country:US
Mailing Address - Phone:504-885-6435
Mailing Address - Fax:504-888-0323
Practice Address - Street 1:4415 SHORES DR
Practice Address - Street 2:SUITE 220
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70006-6804
Practice Address - Country:US
Practice Address - Phone:504-887-5780
Practice Address - Fax:504-888-0323
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA3436235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist