Individual
STACY LYNN TAYLOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA CCC/SLP-L
Contact information
Practice address
6150 GLEBE DR, INDIANAPOLIS, IN 46237-9038
(317) 902-6717
Mailing address
6150 GLEBE DR, INDIANAPOLIS, IN 46237-9038
(173) 902-6717
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
22005051
IN
235Z00000X
Speech-Language Pathologist
Primary
22005105A
IN
235Z00000X
Speech-Language Pathologist
SL002668L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001944653
—
PA
Enumeration date
11/18/2008
Last updated
06/07/2024
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