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Individual
STACY ANN SMALL
Active
Individual
STACY ANN SMALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
1776
NC
Other
Enumeration date
05/02/2007
Last updated
07/08/2007
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