Individual
MRS. STACY BLACKWELL MAGGIO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SA-C
Contact information
Practice address
1150 ROBERT BLVD, SUITE 240, SLIDELL, LA 70458-2004
(985) 718-9392
(985) 249-5092
Mailing address
1150 ROBERT BLVD, SUITE 240, SLIDELL, LA 70458-2004
(985) 718-9392
(985) 249-5092
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
—
LA
Other
Enumeration date
03/28/2017
Last updated
03/28/2017
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