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General NPI Number Information
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NPI Number | 1891096905
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Entity Type | Individual
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Provider Name | STANLEY A VANELLA MS
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Gender | Male
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Dates
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Enumeration Date | 11/04/2010
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Last Update Date | 11/04/2010
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Provider Practice Location Address
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Address Line | 605 HARRIS ST
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City | EUREKA
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State | CA
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Zip | 95503-4447
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Country | US
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Telephone | 707-442-2774
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Fax | 707-442-1834
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Provider Business Mailing Address
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Address Line | 605 HARRIS ST
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City | EUREKA
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State | CA
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Zip | 95503-4447
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Country | US
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Telephone | 707-442-2774
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Fax | 707-442-1834
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 12611
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License Number State | CA
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