STACY ELIZABETH BASTIN

BRIDGEPORT, WV
NPI1174727283
Former NameSTACY ELIZABETH DRAKE
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy235Z00000X Speech-Language Pathologist,
(Licence: WV  SLP 0710)
Enumeration Date2007-06-13
Last Update Date2007-07-09
Business Address
Mrs. STACY ELIZABETH BASTIN MA CCC SLP
765 BRIGHTRIDGE DR
BRIDGEPORT, WV 26330-1172
Phone number: 304-844-0099
Mailing Address
Mrs. STACY ELIZABETH BASTIN MA CCC SLP
765 BRIGHTRIDGE DR
BRIDGEPORT, WV 26330-1172
Phone number: 304-844-0099
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