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Individual

STEPHANIE HALTER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MCD CFY-SLP

Contact information

Practice address
1110 N WESTWOOD BLVD, POPLAR BLUFF, MO 63901-3336
(573) 776-3627
Mailing address
1110 N WESTWOOD BLVD, POPLAR BLUFF, MO 63901-3336
(573) 776-3627

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2015007165
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1811063233
MO
Enumeration date
06/04/2015
Last updated
06/04/2015
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