Individual
DR. STACI LAINE SHUTTLEWORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AUD
Contact information
Practice address
1719 8TH AVE, FORT WORTH, TX 76110-1349
(682) 303-0341
Mailing address
218 W BROADWAY AVE APT 616, FORT WORTH, TX 76104-1335
(501) 288-0182
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
81753
TX
Other
Enumeration date
06/17/2025
Last updated
06/17/2025
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