Lakeside Therapy Group

NPI 1033312574 - Speech-Language Pathologist - 235Z00000X

NPI Details
NPI 1033312574
Enumeration Date 06/11/2007
Last Updated 07/09/2007
Entity Type Healthcare Provider
Active Over 9 years ago
Authorized Information
Name STACY ELIZABETH STACY
Position MEMBER SPEECH THERAPIST
Phone (304) 844-0099
Fax (304) 848-0265
Practice Location
765 BRIGHTRIDGE DRIVE
BRIDGEPORT WV, 26330, US
Phone (304) 844-0099
Fax (304) 848-0265
Business Location
765 BRIGHTRIDGE DRIVE
BRIDGEPORT WV, 26330, US
Phone (304) 844-0099
Fax (304) 848-0265
Toxanomy
Taxonomy Code 235Z00000X
License State West Virginia
License Number SLP 0710
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According to our database, Lakeside Therapy Group NPI is 1033312574, taxonomy code is 235Z00000X and license number is SLP 0710, license state is located at West Virginia. Lakeside Therapy Group physically located at 765 Brightridge Drive, Bridgeport WV, 26330. NPI Number 1033115704 has the healthcare provider type.

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1033312574 NPI number is provided on an as is basis without warranty of any kind. 1033312574 is maintained by the National Plan & Provider Enumeration System. The contents of Lakeside Therapy Group are for informational purposes only.