Provider Demographics
NPI:1215496476
Name:GIAMPOLA, STEPHANIE ANNE (CCC-SLP)
Entity type:Individual
Prefix:MISS
First Name:STEPHANIE
Middle Name:ANNE
Last Name:GIAMPOLA
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:720 ATHANIA PKWY
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70001-4006
Mailing Address - Country:US
Mailing Address - Phone:337-258-7653
Mailing Address - Fax:
Practice Address - Street 1:1050 MEDICAL CENTER BLVD
Practice Address - Street 2:
Practice Address - City:MARRERO
Practice Address - State:LA
Practice Address - Zip Code:70072-3144
Practice Address - Country:US
Practice Address - Phone:504-347-0777
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-18
Last Update Date:2019-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA7635235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist