# MIDLANDS THERAPY

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1598117608
- **Authorized official:** MRS. JESSICA K STATON MA CCC-SLP (SPEECH-LANGUAGE PATHOLOGIST)
- **Authorized official phone:** (606) 282-8270

## Contact information

- **Practice address:** 225 VISTA SPRINGS CIR, LEXINGTON, SC 29072-8119
- **Practice address phone:** (803) 359-3195
- **Mailing address:** PO BOX 139, 207 RUSSELL STREET, BURGIN, KY 40310-0139
- **Mailing address phone:** (606) 282-8270

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 252Y00000X | Early Intervention Provider Agency | 6023 | SC | Yes |

## Other

- **Enumeration date:** 07/13/2016
- **Last updated:** 07/13/2016