Individual
SHANA STANLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
1490 PARK AVE NW, NORTON, VA 24273-1631
(276) 439-1450
Mailing address
304 CHESTNUT ST NW, NORTON, VA 24273-1402
(276) 870-7511
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2202005769
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DSLLS619
LONG TERM CARE
VA
Enumeration date
10/18/2021
Last updated
10/18/2021
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