NPI 1174727283 · live from the CMS NPI Registry
Stacy Elizabeth Bastin, MA CCC SLP
Speech-Language Pathologist, in Bridgeport, WV. National Provider Identifier 1174727283, active.
NPI record
| NPI | 1174727283 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Speech-Language Pathologist, 235Z00000X |
| Practice location | 765 Brightridge Dr, Bridgeport, WV 26330 |
| Practice phone | 304-844-0099 |
| Enumerated | June 13, 2007 |
| Last updated | July 9, 2007 |
| Sole proprietor | No |
| Other names | Stacy Drake |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Speech-Language Pathologist, primary | 235Z00000X | SLP 0710 (WV) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.