Individual
RAEGAN MAE STANLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
900 COMMONWEALTH PL STE 200, VIRGINIA BEACH, VA 23464-4530
(570) 317-1997
Mailing address
650 N SHORELINE DR, WASILLA, AK 99654-6677
(907) 376-6363
(907) 376-6366
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2202009502
VA
235Z00000X
Speech-Language Pathologist
34243
CA
235Z00000X
Speech-Language Pathologist
SL012895
PA
237600000X
Audiologist-Hearing Aid Fitter
10975
MD
Other
Enumeration date
06/16/2016
Last updated
08/26/2025
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