Provider Demographics
NPI:1154531804
Name:CARMICAL, STEPHANY NICHOLE (MS, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:STEPHANY
Middle Name:NICHOLE
Last Name:CARMICAL
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:STEPHANY
Other - Middle Name:NICHOLE
Other - Last Name:BARNETTE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, CCC-SLP
Mailing Address - Street 1:17 BERRY PATCH CV
Mailing Address - Street 2:
Mailing Address - City:CABOT
Mailing Address - State:AR
Mailing Address - Zip Code:72023-3853
Mailing Address - Country:US
Mailing Address - Phone:501-351-5513
Mailing Address - Fax:
Practice Address - Street 1:201 W 22ND ST
Practice Address - Street 2:
Practice Address - City:NORTH LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72114-2203
Practice Address - Country:US
Practice Address - Phone:501-351-5513
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-23
Last Update Date:2023-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR2079235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist