Individual
STACIE MAREE CLAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA,CCC-SLP
Contact information
Practice address
6701 SOUTH ANTHONY BLVD., FORT WAYNE, IN 46816-2035
(260) 447-1591
Mailing address
5148 INDIANOLA AVE, INDIANAPOLIS, IN 46205-1229
(317) 366-5084
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
22004452A
IN
Other
Enumeration date
04/03/2012
Last updated
04/03/2012
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