| NPI | 1033312574 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STACY ELIZABETH BASTIN Member Speech Therapist 304-844-0099 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist (Licence: WV SLP 0710) |
| Enumeration Date | 2007-06-11 |
| Last Update Date | 2020-08-22 |