Individual
MISS STEPHANIE DENISE BOONE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS ED, CF-SLP
Contact information
Practice address
1400 FORDHAM DR, VIRGINIA BEACH, VA 23464-5368
(757) 361-3951
(757) 361-3958
Mailing address
1400 FORDHAM DR, VIRGINIA BEACH, VA 23464-5368
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2202005222
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2202005222
VIRGINIA LICENSE
VA
Enumeration date
07/15/2007
Last updated
07/15/2007
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