Individual
MR. STANLEY MARK SWENTKOWSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.C.D., CCC-SLP
Contact information
Practice address
1742 CHERYL ST, CLARKSDALE, MS 38614-7218
(662) 627-5247
(662) 627-1739
Mailing address
PO BOX 182, 1742 CHERYL STREET, CLARKSDALE, MS 38614-0182
(662) 627-5247
(662) 627-1739
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
S0139
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00120102
—
MS
Enumeration date
10/02/2006
Last updated
07/09/2007
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