NPI 1871663013 · live from the CMS NPI Registry
Stacy Broadhurst, SLP
Speech-Language Pathologist, in Morgantown, WV. National Provider Identifier 1871663013, active.
NPI record
| NPI | 1871663013 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Speech-Language Pathologist, 235Z00000X |
| Practice location | 1 Medical Center Drive, Morgantown, WV 26506 |
| Practice phone | 304-598-4118 |
| Mailing address | 1610 Michael Ln, Fairmont, WV 26554 |
| Enumerated | November 8, 2006 |
| Last updated | July 8, 2007 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Speech-Language Pathologist, primary | 235Z00000X | 0707 (WV) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.