Individual
CARLOS DION STALEY SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.A., CCC-SLP
Contact information
Practice address
4 FOXFIELD LN, BLYTHEWOOD, SC 29016-9134
(803) 673-3985
(803) 542-7085
Mailing address
4 FOXFIELD LN, BLYTHEWOOD, SC 29016-9134
(803) 673-3985
(803) 542-7085
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
3556
SC
Other
Enumeration date
08/21/2012
Last updated
08/21/2012
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