Provider Demographics
NPI:1235514290
Name:PAMFILIS, STACI (MS)
Entity type:Individual
Prefix:MRS
First Name:STACI
Middle Name:
Last Name:PAMFILIS
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:STACI
Other - Middle Name:
Other - Last Name:LEMASTERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS
Mailing Address - Street 1:3015 RED GRAPE DR.
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27607-4865
Mailing Address - Country:US
Mailing Address - Phone:919-610-9298
Mailing Address - Fax:919-439-6380
Practice Address - Street 1:3015 RED GRAPE DR.
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27607-4865
Practice Address - Country:US
Practice Address - Phone:919-610-9298
Practice Address - Fax:919-439-6380
Is Sole Proprietor?:No
Enumeration Date:2015-07-20
Last Update Date:2017-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1603087235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist