Provider Demographics
NPI:1679899082
Name:CARLSON, STEPHANIE ROUGH (MS)
Entity type:Individual
Prefix:MRS
First Name:STEPHANIE
Middle Name:ROUGH
Last Name:CARLSON
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:STEPHANIE
Other - Middle Name:ROUGH
Other - Last Name:ARTRIP
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS
Mailing Address - Street 1:222 PIEDMONT AVE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45219-4231
Mailing Address - Country:US
Mailing Address - Phone:513-475-8400
Mailing Address - Fax:513-475-8228
Practice Address - Street 1:222 PIEDMONT AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45219-4231
Practice Address - Country:US
Practice Address - Phone:513-475-8400
Practice Address - Fax:513-475-8228
Is Sole Proprietor?:No
Enumeration Date:2010-04-09
Last Update Date:2016-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHA 01010231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist