Doctor Name: | MRS. STACIE CHRISTINE CARRELL |
NPI Number: | 1063726172 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | STACIE BATEMAN |
License Number: | 12858 |
Business Practice Address: | 46 Orange Blossom Irvine, CA - 926184400 |
Business Phone Number: | 7149434944 |
Business Fax Number: | 9492714941 |
Mailing Address: | 46 Orange Blossom, IRVINE |
State: | CA |
Postal Code: | 926184400 |
Phone Number: | 7149434944 |
Fax Number: | 9492714941 |
NPI Enumeration Date: | 07/30/2010 |
NPI Last Update Date: | 07/30/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 12858 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |