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Individual
MRS. STACY LYNN DORNER
Active
Individual
MRS. STACY LYNN DORNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SLP-CCC
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SL005805L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
24-6000376
THE PENNSYLVANIA STATE UNIVERSITY
PA
Enumeration date
11/29/2011
Last updated
11/29/2011
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