Individual
STACY JANE KEYES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S.,SLP
Contact information
Practice address
405 MEMORIAL BLVD, PICAYUNE, MS 39466-5545
(769) 242-2636
Mailing address
405 MEMORIAL BLVD, PICAYUNE, MS 39466-5545
(769) 242-2636
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
S-5291
MS
Other
Enumeration date
12/10/2024
Last updated
12/10/2024
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