Provider Demographics
NPI:1891038360
Name:STALLBAUMER, DARCEL AMBER (MS/CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:DARCEL
Middle Name:AMBER
Last Name:STALLBAUMER
Suffix:
Gender:F
Credentials:MS/CCC-SLP
Other - Prefix:MISS
Other - First Name:DARCEL
Other - Middle Name:AMBER
Other - Last Name:GRONEWOLLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS/CCC-SLP
Mailing Address - Street 1:276 2ND ST
Mailing Address - Street 2:
Mailing Address - City:BAILEYVILLE
Mailing Address - State:KS
Mailing Address - Zip Code:66404-8477
Mailing Address - Country:US
Mailing Address - Phone:785-738-0060
Mailing Address - Fax:
Practice Address - Street 1:276 2ND ST
Practice Address - Street 2:
Practice Address - City:BAILEYVILLE
Practice Address - State:KS
Practice Address - Zip Code:66404-8477
Practice Address - Country:US
Practice Address - Phone:785-738-0060
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-02
Last Update Date:2013-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS3346235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist