| Doctor Name: | MRS. STACIE L PARDUE |
| NPI Number: | 1578609111 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MA |
| License Number: | SLP007210 |
| Business Practice Address: | 4440b 26th St W Bradenton, FL - 342071201 |
| Business Phone Number: | 9417520408 |
| Business Fax Number: | 9418700876 |
| Mailing Address: | 4016 Cortez Rd W, Suite 1105 BRADENTON |
| State: | FL |
| Postal Code: | 342103110 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 01/30/2007 |
| NPI Last Update Date: | 10/29/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | SLP007210 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | GA |
| 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 |