Healthcare Provider Details

I. General information

NPI: 1861326043
Provider Name (Legal Business Name): STACY ANN GAY MS, CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/11/2026
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6605 ROCK RIDGE SCHOOL RD
WILSON NC
27893-7756
US

IV. Provider business mailing address

117 TARBORO ST NE
WILSON NC
27893-4016
US

V. Phone/Fax

Practice location:
  • Phone: 252-399-7955
  • Fax:
Mailing address:
  • Phone: 252-399-7900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number09141773
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: