Most Relevant Information
Provider Data
| NPI Number: | 1003463423 |
| Provider Name: | STEPHANIE VU SHICKSNIDER |
| Entity Type: | Individual |
| Taxonomy Code: | 235Z00000X |
| Specialty: | Speech-Language Pathologist |
| License Number: |
Most Important Dates
| Enumeration Date: | 08/20/2019 |
| Last Updated: | 08/20/2019 |
Provider Practice Location
138 W 116TH ST
CUT OFF
LA
703453644
Practice Location Phone/Fax
| Phone: | 3372561419 |
| Fax: |
Provider Mailing Location
138 W 116TH ST
CUT OFF
LA
703453644
Provider Mailing Phone/Fax
| Phone: | 3372561419 |
| Fax: |