Organization
MIDLANDS THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JESSICA K STATON MA CCC-SLP (SPEECH-LANGUAGE PATHOLOGIST)
(606) 282-8270
Entity
Organization
Contact information
Practice address
225 VISTA SPRINGS CIR, LEXINGTON, SC 29072-8119
(803) 359-3195
Mailing address
PO BOX 139, 207 RUSSELL STREET, BURGIN, KY 40310-0139
(606) 282-8270
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
6023
SC
Other
Enumeration date
07/13/2016
Last updated
07/13/2016
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