Individual
KELLY STACY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7000 W 121ST ST STE 110, OVERLAND PARK, KS 66209-2011
(913) 912-2174
Mailing address
12138 W 97TH ST APT 309, LENEXA, KS 66215-1629
(913) 232-1617
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Enumeration date
03/05/2021
Last updated
08/21/2022
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