Provider Demographics
NPI:1992166508
Name:BEHMER, STASIA (MA, CCC-SLP, BCBA)
Entity type:Individual
Prefix:MRS
First Name:STASIA
Middle Name:
Last Name:BEHMER
Suffix:
Gender:F
Credentials:MA, CCC-SLP, BCBA
Other - Prefix:
Other - First Name:STASIA
Other - Middle Name:ALINA
Other - Last Name:GIEGUCZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:87 TAYLOR RD
Mailing Address - Street 2:
Mailing Address - City:STOW
Mailing Address - State:MA
Mailing Address - Zip Code:01775-1613
Mailing Address - Country:US
Mailing Address - Phone:508-439-0047
Mailing Address - Fax:
Practice Address - Street 1:364 BOSTON TPKE
Practice Address - Street 2:1A
Practice Address - City:SHREWSBURY
Practice Address - State:MA
Practice Address - Zip Code:01545-3869
Practice Address - Country:US
Practice Address - Phone:508-757-6981
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-09
Last Update Date:2016-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA9238235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist