Individual
GINA STOVALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S., CCC-SLP
Contact information
Practice address
400 HERITAGE AVE, CASTLE ROCK, CO 80104-8726
(303) 387-5150
Mailing address
3221 ARNICA WAY, FRANKTOWN, CO 80116-8782
(512) 750-6467
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
1107
TX
235Z00000X
Speech-Language Pathologist
Primary
PSLP.0000785
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
18-69273
BEHAVIOR ANALYST CERTIFICATION BOARD (BACB)
—
Enumeration date
11/27/2018
Last updated
10/10/2024
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