Individual
PAMELA S STAFFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
518 N HAMPTON AVE, REPUBLIC, MO 65738-1323
(417) 732-3605
(417) 732-3609
Mailing address
518 N HAMPTON AVE, REPUBLIC, MO 65738-1323
(417) 732-3605
(417) 732-3609
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
01975
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
464450402
—
MO
Enumeration date
02/23/2007
Last updated
08/02/2010
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