Individual
STACIA DAWN DEMOSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AU.D.
Contact information
Practice address
1425 EARL L CORE RD, MORGANTOWN, WV 26505-5885
(304) 413-0184
(304) 413-0185
Mailing address
1425 EARL L CORE RD, MORGANTOWN, WV 26505-5885
(304) 413-0184
(304) 413-0185
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
A-0288
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12140181
ASHA CERTIFICATE OF CLINICAL COMPETENCE
—
01
—
A-0288
STATE OF WV LICENSE
WV
Enumeration date
12/12/2012
Last updated
06/11/2013
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