Provider Demographics
NPI:1699660993
Name:JONES, STEPHANIE JEAN (SLP)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:JEAN
Last Name:JONES
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:419 E COZY ST
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65807-1617
Mailing Address - Country:US
Mailing Address - Phone:417-298-0748
Mailing Address - Fax:
Practice Address - Street 1:1409 NE DIAMOND LAKE BLVD STE 110
Practice Address - Street 2:
Practice Address - City:ROSEBURG
Practice Address - State:OR
Practice Address - Zip Code:97470-3356
Practice Address - Country:US
Practice Address - Phone:541-440-4777
Practice Address - Fax:541-440-4771
Is Sole Proprietor?:No
Enumeration Date:2025-06-09
Last Update Date:2025-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR016264235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist