Healthcare Provider Details

I. General information

NPI: 1184729394
Provider Name (Legal Business Name): STEPHANIE LYN HUFF MS, CCC/SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/13/2006
Last Update Date: 05/14/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9355 SAN JOSE BLVD
JACKSONVILLE FL
32257
US

IV. Provider business mailing address

312 FIREFLY TRCE
ST AUGUSTINE FL
32092-9377
US

V. Phone/Fax

Practice location:
  • Phone: 904-739-0877
  • Fax:
Mailing address:
  • Phone: 904-434-0059
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSA15673
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSLP007867
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: