Individual
STACI BURLESON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, CCC-SLP
Contact information
Practice address
7112 UNIVERSITY CT, MONTGOMERY, AL 36117-8045
(334) 612-7176
Mailing address
7112 UNIVERSITY CT, MONTGOMERY, AL 36117-8045
(719) 332-6190
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
1858
HI
235Z00000X
Speech-Language Pathologist
Primary
5528
AL
Other
Enumeration date
08/05/2021
Last updated
01/14/2024
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