Doctor Name: | STACIA G CHILDS |
NPI Number: | 1255576096 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MS, CCC-SLP |
License Number: | 2006026271 |
Business Practice Address: | 7620 Metcalf Ave Suite M Overland Park, KS - 662042928 |
Business Phone Number: | 9133839014 |
Business Fax Number: | |
Mailing Address: | 721 Corrington Dr, RAYMORE |
State: | MO |
Postal Code: | 640838271 |
Phone Number: | 8163226426 |
Fax Number: | |
NPI Enumeration Date: | 12/08/2008 |
NPI Last Update Date: | 12/08/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 2006026271 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | MO |
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 |