Individual
TYLA STUCKEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
200 FORTRESS DRIVE, CHAPIN, SC 29036
(803) 732-3000
Mailing address
137 ROSEBERRY LN APT 2121, COLUMBIA, SC 29223-2863
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
7580
SC
Other
Enumeration date
06/03/2021
Last updated
06/03/2021
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