Provider Demographics
NPI:1487944278
Name:FRANK, STEPHANIE JILL (CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:STEPHANIE
Middle Name:JILL
Last Name:FRANK
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 1:7025 YELLOWSTONE BLVD
Mailing Address - Street 2:17Y
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375-3164
Mailing Address - Country:US
Mailing Address - Phone:516-582-3031
Mailing Address - Fax:
Practice Address - Street 1:7025 YELLOWSTONE BLVD
Practice Address - Street 2:17Y
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375-3164
Practice Address - Country:US
Practice Address - Phone:516-582-3031
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-13
Last Update Date:2011-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY020558-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist