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General NPI Number Information
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NPI Number | 1922180165
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Entity Type | Individual
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Provider Name | CASSIE LAKE STROUD M.A., CCC-S
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Gender | Female
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Dates
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Enumeration Date | 10/19/2006
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | 3427 US ROUTE 60 EAST
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City | BARBOURSVILLE
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State | WV
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Zip | 25504
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Country | US
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Telephone | 304-736-8255
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Fax | 304-736-4851
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Provider Business Mailing Address
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Address Line | PO BOX 232
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City | CULLODEN
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State | WV
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Zip | 25510-0232
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Country | US
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Telephone | 304-736-8255
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Fax | 304-736-4851
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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 | SLP0777
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License Number State | WV
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