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NPI Code Detail

MEDICARE: AMBER STACY

MEDICARE: AMBER STACY
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1235Z00000XSpeech-Language Pathologist2202004833VA

General Provider Information

NPI Number : 1801417340
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMBER STACY
Provider Business Mailing Address
First Line : 100 CRITZER DR
Second Line :
City : PULASKI
State : VA
Zip : 24301-7007
Country : US
Telephone Number : 304-952-9106
Fax Number :
Provider Business Practice Location Address
First Line : 202 N WASHINGTON AVE
Second Line :
City : PULASKI
State : VA
Zip : 24301-5022
Country : US
Telephone Number : 540-643-0526
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/06/2020
Last Update Date : 05/06/2020

Similar Medicare Providers

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Practice Location Address:
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1538832274 — MISS CHRYSTAL MARIE BOOTHE MA, BCBA, LBA
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Directions to “ AMBER STACY ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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