Individual
DR. STACEY BAUST
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
1209 CARNEY RD, CHARLESTON, WV 25314-1226
(830) 328-3142
Mailing address
1209 CARNEY RD, CHARLESTON, WV 25314-1226
(830) 328-3142
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
01/30/2019
Last updated
07/26/2022
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