Individual
STACEY NICOLE VAWTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
200 NURSING HOME LN, PIKEVILLE, KY 41501-6896
(606) 639-4840
Mailing address
2593 HUNTSVILLE HWY, FAYETTEVILLE, TN 37334-3772
(256) 683-7392
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
251357
KY
235Z00000X
Speech-Language Pathologist
4226
AL
235Z00000X
Speech-Language Pathologist
46002699A
IN
Other
Enumeration date
06/13/2015
Last updated
04/27/2020
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