Doctor Name: | STACEY LYNN CANTRELL |
NPI Number: | 1417183062 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.S., CCC-SLP |
License Number: | 5522 |
Business Practice Address: | 200 Crighton Rdg Bossier City, LA - 711116348 |
Business Phone Number: | 3187735719 |
Business Fax Number: | 3184253236 |
Mailing Address: | 200 Crighton Rdg, BOSSIER CITY |
State: | LA |
Postal Code: | 711116348 |
Phone Number: | 3187735719 |
Fax Number: | 3184253236 |
NPI Enumeration Date: | 06/09/2009 |
NPI Last Update Date: | 06/09/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 5522 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | LA |
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 |