Provider Demographics
NPI:1306159231
Name:STEDMAN, JENNY MCEWEN (SLPA)
Entity type:Individual
Prefix:MRS
First Name:JENNY
Middle Name:MCEWEN
Last Name:STEDMAN
Suffix:
Gender:F
Credentials:SLPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1082 W AMANDA LN
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85284-3745
Mailing Address - Country:US
Mailing Address - Phone:480-785-9066
Mailing Address - Fax:
Practice Address - Street 1:2450 W SOUTH MOUNTAIN AVE
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85041-7601
Practice Address - Country:US
Practice Address - Phone:602-323-5400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-20
Last Update Date:2010-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZSLPA63662355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant