Individual
MRS. STACEY SHIPMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
4778 OVERTON ROAD, BIRMINGHAM, AL 35210
(205) 957-0294
(205) 957-0298
Mailing address
4778 OVERTON ROAD, BIRMINGHAM, AL 35210
(205) 957-0294
(205) 957-0298
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2405
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
515-32413
BCBS OF AL PROVIDER #
AL
Enumeration date
10/02/2006
Last updated
07/08/2007
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