Stacy Faller, MA/CCC-SLP
Individual provider Active NPI Speech-Language Pathologist · Fort Recovery, OH
NPI 1124445408 · NPPES record last updated Mar 25, 2014
Key facts
- NPI
- 1124445408
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- SP 7561 (OH)
- Practice address
- 865 Sharpsburg Rd
Fort Recovery, OH 45846-9746 - Phone
- (419) 375-2768
- NPI assigned
- Mar 25, 2014
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SP 7561 | OH | MD | Speech-Language Pathologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | SP 7561 | OH | Yes |
Addresses
Primary practice location
865 Sharpsburg Rd
Fort Recovery, OH 45846-9746
Mailing address
441 E Market St
Celina, OH 45822-1736
Phone (419) 586-6628
Other providers in Fort Recovery, OH
- Lauren Elizabeth Broering
- Erin Heather Burns
- Carr Corporation
- Daniel Joseph Carr
- Theresa Maria Detomaso
- Fort Family Health Inc.
- Fort Recovery Local School District
- Ft Recovery Chiropractic, LLC
- Ft Recovery Family Medicine, Inc
- Monica Mary Fullenkamp
All providers in Fort Recovery, OH · Speech-Language Pathologist in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 25, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.