Individual
STACY R. DESUTTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S., CCC-SLP
Contact information
Practice address
ST. JOHN'S REGIONAL MEDICAL CENTER, 2727 MCCLELLAND BLVD, JOPLIN, MO 64804
(417) 625-2498
(417) 625-2097
Mailing address
1608 JOPLIN ST, SARCOXIE, MO 64862-9251
(417) 548-3906
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
102022
MO
Other
Enumeration date
05/09/2007
Last updated
07/08/2007
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