Individual
STACEY L WHITE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
25 PARK ST, KINGMAN, ME 04451-3202
(207) 765-2500
Mailing address
25 PARK ST, KINGMAN, ME 04451-3202
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SP1568
ME
Other
Enumeration date
05/26/2011
Last updated
07/29/2021
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