Healthcare Provider Details

I. General information

NPI: 1710802210
Provider Name (Legal Business Name): STELLA SPEECH THERAPY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/12/2026
Last Update Date: 08/12/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3905 US 29 BUS
DANVILLE VA
24540
US

IV. Provider business mailing address

1180 DAVID GILES LN
BLAIRS VA
24527-3768
US

V. Phone/Fax

Practice location:
  • Phone: 434-661-5352
  • Fax: 434-302-9988
Mailing address:
  • Phone: 434-661-5352
  • Fax: 434-302-9988

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MRS. JENNIFER KRISTINE CHACON
Title or Position: SPEECH-LANGUAGE PATHOLOGIST
Credential: M.S. CCC-SLP
Phone: 434-661-5352