Provider Demographics
NPI:1144496035
Name:HATFIELD, STACIE MERI (EDD, CCC-SLP)
Entity type:Individual
Prefix:DR
First Name:STACIE
Middle Name:MERI
Last Name:HATFIELD
Suffix:
Gender:F
Credentials:EDD, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2121 26TH ST
Mailing Address - Street 2:
Mailing Address - City:ROCK ISLAND
Mailing Address - State:IL
Mailing Address - Zip Code:61201-4659
Mailing Address - Country:US
Mailing Address - Phone:309-269-7594
Mailing Address - Fax:
Practice Address - Street 1:639 38TH ST
Practice Address - Street 2:
Practice Address - City:ROCK ISLAND
Practice Address - State:IL
Practice Address - Zip Code:61201-2296
Practice Address - Country:US
Practice Address - Phone:309-794-7394
Practice Address - Fax:309-794-3497
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-01
Last Update Date:2025-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146006717235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist