Provider Demographics
NPI:1194511493
Name:SWAIN, STACIE (HIS)
Entity type:Individual
Prefix:MRS
First Name:STACIE
Middle Name:
Last Name:SWAIN
Suffix:
Gender:
Credentials:HIS
Other - Prefix:MS
Other - First Name:STACIE
Other - Middle Name:
Other - Last Name:SWAIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:HIS
Mailing Address - Street 1:5038 ELNO AVE
Mailing Address - Street 2:
Mailing Address - City:NEW FRANKLIN
Mailing Address - State:OH
Mailing Address - Zip Code:44319-4932
Mailing Address - Country:US
Mailing Address - Phone:330-715-9352
Mailing Address - Fax:
Practice Address - Street 1:5038 ELNO AVE
Practice Address - Street 2:
Practice Address - City:NEW FRANKLIN
Practice Address - State:OH
Practice Address - Zip Code:44319-4932
Practice Address - Country:US
Practice Address - Phone:330-715-9352
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-15
Last Update Date:2025-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03378237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist