Individual
MRS. STACY L DALTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S. CCC-SLP
Contact information
Practice address
1401 WESTHAMPTON DR, LITTLE ROCK, AR 72211-4069
(501) 223-9104
Mailing address
1401 WESTHAMPTON DR, LITTLE ROCK, AR 72211-4069
(501) 223-9104
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
1720
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5W448
BLUE CROSS NUMBER
AR
Enumeration date
06/12/2007
Last updated
07/08/2007
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