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Individual

TASHA MARTIN-STANFORD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
4820 QUEEN RIDGE AVE, APT 732, KANSAS CITY, MO 64136-1423
(816) 373-4841
Mailing address
4820 QUEEN RIDGE AVE, APT 732, KANSAS CITY, MO 64136-1423

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
01850
KS
235Z00000X
Speech-Language Pathologist
Primary
116968
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
464777424
MO
Enumeration date
02/14/2007
Last updated
07/08/2007
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