Individual
MISS STACY CHANTEL ROTHENBERGER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S. CCC-SLP, CLC
Contact information
Practice address
112 ROCKRIDGE CT, LEXINGTON, SC 29072-7970
(803) 520-4091
Mailing address
112 ROCKRIDGE CT, LEXINGTON, SC 29072-7970
(803) 520-4091
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
253737
SC
Other
Enumeration date
06/26/2012
Last updated
06/26/2012
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