Healthcare Provider Details

I. General information

NPI: 1558435214
Provider Name (Legal Business Name): KAY JOYCE STANTON M.S. CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/17/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

85 NE LOOP 410 SUITE 209
SAN ANTONIO TX
78216-5829
US

IV. Provider business mailing address

9555 AQUA VERDE
HELOTES TX
78023-4130
US

V. Phone/Fax

Practice location:
  • Phone: 210-340-2627
  • Fax: 210-340-6437
Mailing address:
  • Phone: 210-340-2627
  • Fax: 210-340-6437

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number16787
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: