Provider Demographics
NPI:1194884056
Name:ENEY, STEPHANIE ROSE
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:ROSE
Last Name:ENEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1205 YORK RD
Mailing Address - Street 2:SUITE 33
Mailing Address - City:LUTHERVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21093-6210
Mailing Address - Country:US
Mailing Address - Phone:410-494-7060
Mailing Address - Fax:410-832-5202
Practice Address - Street 1:1205 YORK RD
Practice Address - Street 2:SUITE 33
Practice Address - City:LUTHERVILLE
Practice Address - State:MD
Practice Address - Zip Code:21093-6210
Practice Address - Country:US
Practice Address - Phone:410-494-7060
Practice Address - Fax:410-832-5202
Is Sole Proprietor?:No
Enumeration Date:2006-12-07
Last Update Date:2014-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD00201231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist