MEDICARE: STACEY LEANN NEPVEUX MS, CCC-SLP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	103383	TX

General Provider Information

NPI Number	:	1073025110
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STACEY LEANN NEPVEUX MS, CCC-SLP

Provider Business Mailing Address
First Line	:	1424 RED DR
Second Line	:
City	:	LITTLE ELM
State	:	TX
Zip	:	75068-3429
Country	:	US
Telephone Number	:	214-783-1221
Fax Number	:

Provider Business Practice Location Address
First Line	:	9711 BIRDSNEST CT
Second Line	:
City	:	SPRING
State	:	TX
Zip	:	77379-5394
Country	:	US
Telephone Number	:	214-783-1221
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/30/2017
Last Update Date	:	08/22/2022

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