MEDICARE: MRS. STEPHANIE R. O'NEAL MSCCC-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	22004185A	IN

General Provider Information

NPI Number	:	1770729956
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. STEPHANIE R. O'NEAL MSCCC-SLP

Provider Business Mailing Address
First Line	:	963 S THORPE PL
Second Line	:
City	:	WEST TERRE HAUTE
State	:	IN
Zip	:	47885-9506
Country	:	US
Telephone Number	:	812-249-4458
Fax Number	:

Provider Business Practice Location Address
First Line	:	905 SOUTH GORHAM PLACE
Second Line	:
City	:	WEST TERRE HAUTE
State	:	IN
Zip	:	47885
Country	:	US
Telephone Number	:	812-249-4458
Fax Number	:

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

Provider Enumeration Date	:	12/18/2008
Last Update Date	:	12/18/2008

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