Individual
STEPHANIE KELLY DESIR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1015 OAKHURST DR, CHARLESTON, WV 25314-2049
(304) 345-8101
Mailing address
2053 SMITH RD, CHARLESTON, WV 25314-2106
(304) 382-8131
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP-2104
WV
Other
Enumeration date
06/29/2020
Last updated
06/29/2020
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