Individual
STEPHANIE PETRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
1015 OAKHURST DR, CHARLESTON, WV 25314-2049
(304) 345-8101
(304) 345-7586
Mailing address
1015 OAKHURST DR, CHARLESTON, WV 25314-2049
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP-1183
WV
Other
Enumeration date
09/03/2009
Last updated
09/03/2009
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