Individual
AMBER STACY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
202 N WASHINGTON AVE, PULASKI, VA 24301-5022
(540) 643-0526
Mailing address
100 CRITZER DR, PULASKI, VA 24301-7007
(304) 952-9106
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2202004833
VA
Other
Enumeration date
05/06/2020
Last updated
05/06/2020
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