Individual
MRS. ANITA STACKHOUSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
1630 S. BROWNLEE, CORPUS CHRISTI, TX 78404
(361) 980-9652
(361) 980-9652
Mailing address
14621 SPID # O7, CORPUS CHRISTI, TX 78418
(361) 215-2505
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
15035
TX
Other
Enumeration date
05/01/2007
Last updated
07/08/2007
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