Provider Demographics
NPI:1316106651
Name:SLAUGHTER, STACEY E (MA, CCC-SLP)
Entity type:Individual
Prefix:
First Name:STACEY
Middle Name:E
Last Name:SLAUGHTER
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:998 BEECHWOOD PL
Mailing Address - Street 2:
Mailing Address - City:WARMINSTER
Mailing Address - State:PA
Mailing Address - Zip Code:18974-1161
Mailing Address - Country:US
Mailing Address - Phone:215-680-2530
Mailing Address - Fax:
Practice Address - Street 1:998 BEECHWOOD PL
Practice Address - Street 2:
Practice Address - City:WARMINSTER
Practice Address - State:PA
Practice Address - Zip Code:18974-1161
Practice Address - Country:US
Practice Address - Phone:215-680-2530
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-02
Last Update Date:2008-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL007341235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist