Individual
JACLYN STALEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
2500 HOSPITAL DR, MARTINSBURG, WV 25401-3402
(304) 264-1000
Mailing address
2500 HOSPITAL DR, MARTINSBURG, WV 25401-3402
(304) 264-1000
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
05467
MD
235Z00000X
Speech-Language Pathologist
Primary
SLP-1772
WV
Other
Enumeration date
06/13/2017
Last updated
07/21/2022
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