Individual
MR. SCOTT ANTHONY STACY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
SLP
Contact information
Practice address
1101 GLEN OAKS RD., SHELBYVILLE, TN 37160-2529
(931) 684-8340
Mailing address
1226 CRUTCHFIELD ST, ROANOKE, VA 24019-4408
(615) 278-0308
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SP0000001736
TN
Other
Enumeration date
03/02/2010
Last updated
03/02/2010
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