Individual
MRS. STACEY L EVRARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, CCC-SLP
Contact information
Practice address
2424 DOUBLE CHURCHES RD, COLUMBUS, GA 31909-2741
(706) 324-6112
(706) 596-8259
Mailing address
2424 DOUBLE CHURCHES RD, COLUMBUS, GA 31909-2741
(706) 324-6112
(706) 596-8259
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP006583
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
744807441A
—
GA
Enumeration date
05/11/2007
Last updated
03/03/2011
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