Provider Demographics
NPI:1205966603
Name:STADEL, CHARLOTTE ANNE (SLP)
Entity type:Individual
Prefix:MS
First Name:CHARLOTTE
Middle Name:ANNE
Last Name:STADEL
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5110 N 86TH PL
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85250-7406
Mailing Address - Country:US
Mailing Address - Phone:480-949-9491
Mailing Address - Fax:480-947-3001
Practice Address - Street 1:15042 W SWEETWATER AVE
Practice Address - Street 2:
Practice Address - City:SURPRISE
Practice Address - State:AZ
Practice Address - Zip Code:85379-8164
Practice Address - Country:US
Practice Address - Phone:623-523-8225
Practice Address - Fax:623-523-8211
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ593831Medicaid