Healthcare Provider Details

I. General information

NPI: 1083868640
Provider Name (Legal Business Name): KATHY T STIGERS M.A./CCC-A
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/10/2008
Last Update Date: 07/16/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

927 N SPRING GARDEN AVE
DELAND FL
32720-2560
US

IV. Provider business mailing address

1680 DUNLAWTON AVE
PORT ORANGE FL
32127-4754
US

V. Phone/Fax

Practice location:
  • Phone: 386-736-7192
  • Fax:
Mailing address:
  • Phone: 386-756-8225
  • Fax: 386-767-0742

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License NumberAY506
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: