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Individual

MRS. STACY VISAGE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MS-CCC, SLP

Contact information

Practice address
4401 HARRISON BLVD, OGDEN, UT 84403-3195
(801) 387-2800
Mailing address
4367 S 2675 W, ROY, UT 84067-1919

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
8271884-4102
UT

Other

Enumeration date
07/11/2019
Last updated
07/11/2019
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