Individual
STACEY ANNE DE LOS SANTOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1701 LIBRARY BLVD STE A, GREENWOOD, IN 46142-1567
(317) 881-9923
Mailing address
259 SUNCREST DR, GREENWOOD, IN 46143-1023
(317) 999-3409
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
22006164A
IN
Other
Enumeration date
04/02/2024
Last updated
04/02/2024
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