Provider Demographics
NPI:1043485402
Name:AXTELL, STEPHANIE MORRIS (AUD)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:MORRIS
Last Name:AXTELL
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:112 LONGFEATHER LN
Mailing Address - Street 2:
Mailing Address - City:ALABASTER
Mailing Address - State:AL
Mailing Address - Zip Code:35007-5816
Mailing Address - Country:US
Mailing Address - Phone:205-621-1284
Mailing Address - Fax:
Practice Address - Street 1:1940 ELMER J BISSELL RD
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35243-2941
Practice Address - Country:US
Practice Address - Phone:205-824-4847
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-28
Last Update Date:2008-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL851A231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist