Provider Demographics
NPI:1770736696
Name:PILSNER, STEPHANIE CATHERINE (SLP-CCC, BCBA)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:CATHERINE
Last Name:PILSNER
Suffix:
Gender:F
Credentials:SLP-CCC, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 GENESIS BLVD STE D
Mailing Address - Street 2:
Mailing Address - City:WEBSTER
Mailing Address - State:TX
Mailing Address - Zip Code:77598-1636
Mailing Address - Country:US
Mailing Address - Phone:832-569-4316
Mailing Address - Fax:832-838-4458
Practice Address - Street 1:210 GENESIS BLVD STE D
Practice Address - Street 2:
Practice Address - City:WEBSTER
Practice Address - State:TX
Practice Address - Zip Code:77598-1636
Practice Address - Country:US
Practice Address - Phone:832-569-4316
Practice Address - Fax:832-838-4458
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-23
Last Update Date:2023-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX4199103K00000X
TX104437235Z00000X
103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty