Individual
MS. STACIE LAVONNE JUDE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
5842 KINGS GROVE DR, CHESTERFIELD, VA 23832-7895
(804) 743-1722
Mailing address
5842 KINGS GROVE DR, CHESTERFIELD, VA 23832-7895
(804) 743-1722
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2202003249
VA
Other
Enumeration date
08/18/2010
Last updated
08/18/2010
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