Individual
STACIE CARLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
520 S 1ST AVE, SIOUX FALLS, SD 57104-6902
(605) 336-7561
Mailing address
740 FOX CT, TEA, SD 57064-3214
(605) 593-1877
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
60526-01
SD
Other
Enumeration date
10/10/2008
Last updated
07/15/2020
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