Provider Demographics
NPI:1538402425
Name:STADFELT, SHAI LEE
Entity type:Individual
Prefix:MRS
First Name:SHAI
Middle Name:LEE
Last Name:STADFELT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8111 176TH LN NW
Mailing Address - Street 2:
Mailing Address - City:ANOKA
Mailing Address - State:MN
Mailing Address - Zip Code:55303-5570
Mailing Address - Country:US
Mailing Address - Phone:763-441-1278
Mailing Address - Fax:763-205-2099
Practice Address - Street 1:8111 176TH LN NW
Practice Address - Street 2:
Practice Address - City:ANOKA
Practice Address - State:MN
Practice Address - Zip Code:55303-5570
Practice Address - Country:US
Practice Address - Phone:763-441-1278
Practice Address - Fax:763-205-2099
Is Sole Proprietor?:No
Enumeration Date:2013-03-29
Last Update Date:2013-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2578237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist