Provider Demographics
NPI:1346558160
Name:STERLACE, STEFANIE JEAN (MSED SLP CCC)
Entity type:Individual
Prefix:MRS
First Name:STEFANIE
Middle Name:JEAN
Last Name:STERLACE
Suffix:
Gender:F
Credentials:MSED SLP CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:280 CHOATE AVE
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14220-2001
Mailing Address - Country:US
Mailing Address - Phone:716-238-4674
Mailing Address - Fax:
Practice Address - Street 1:280 CHOATE AVE
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14220-2001
Practice Address - Country:US
Practice Address - Phone:716-238-4674
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-14
Last Update Date:2010-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY019649-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist