Provider Demographics
NPI:1932356615
Name:SPENCER, STEFANIE MARIE (MS, CCC-SLP, LSLS)
Entity Type:Individual
Prefix:MS
First Name:STEFANIE
Middle Name:MARIE
Last Name:SPENCER
Suffix:
Gender:F
Credentials:MS, CCC-SLP, LSLS
Other - Prefix:
Other - First Name:STEFANIE
Other - Middle Name:MARIE
Other - Last Name:MEERT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, CCC-SLP
Mailing Address - Street 1:9816 BALLENTINE ST
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66214-2341
Mailing Address - Country:US
Mailing Address - Phone:913-461-9410
Mailing Address - Fax:
Practice Address - Street 1:8835 MONROVIA ST
Practice Address - Street 2:
Practice Address - City:LENEXA
Practice Address - State:KS
Practice Address - Zip Code:66215-3540
Practice Address - Country:US
Practice Address - Phone:913-383-3535
Practice Address - Fax:913-383-0320
Is Sole Proprietor?:No
Enumeration Date:2008-08-25
Last Update Date:2012-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS2902235Z00000X
MO2008025569235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist