Healthcare Provider Details

I. General information

NPI: 1821763087
Provider Name (Legal Business Name): STEPHANIE NJOKU
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/10/2021
Last Update Date: 08/10/2021
Certification Date: 08/10/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4300 COTTON GIN RD
FRISCO TX
75034-4480
US

IV. Provider business mailing address

502 ISAAC CIR APT C
WYLIE TX
75098-9003
US

V. Phone/Fax

Practice location:
  • Phone: 469-453-0632
  • Fax:
Mailing address:
  • Phone: 972-693-6724
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: