Doctor Name: | MS. MANDY STATON |
NPI Number: | 1215154349 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.S. |
License Number: | 103218 |
Business Practice Address: | 2535 Lone Star Dr Dallas, TX - 752126313 |
Business Phone Number: | 2144679787 |
Business Fax Number: | |
Mailing Address: | 4520 W Amherst Ave, DALLAS |
State: | TX |
Postal Code: | 752093124 |
Phone Number: | 2143505926 |
Fax Number: | |
NPI Enumeration Date: | 04/19/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 103218 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
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 |