Provider Demographics
NPI:1134405772
Name:TRACHTENBERG, STEFANIE SHOSS (MA, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:STEFANIE
Middle Name:SHOSS
Last Name:TRACHTENBERG
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4816 WELFORD DR
Mailing Address - Street 2:
Mailing Address - City:BELLAIRE
Mailing Address - State:TX
Mailing Address - Zip Code:77401-5334
Mailing Address - Country:US
Mailing Address - Phone:713-592-8404
Mailing Address - Fax:
Practice Address - Street 1:4816 WELFORD DR
Practice Address - Street 2:
Practice Address - City:BELLAIRE
Practice Address - State:TX
Practice Address - Zip Code:77401-5334
Practice Address - Country:US
Practice Address - Phone:713-592-8404
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-27
Last Update Date:2016-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX18711235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist