Blackington, Stacy L

Blackington, Stacy L is an individual health care provider with primary practice located at 960 E Walnut Lawn St , Springfield MO 65807-7506. She recently has 2 registered licenses in different health care specialties including Speech, Language and Hearing Service Providers / Audiologist, Speech, Language and Hearing Service Providers / Audiologist-Hearing Aid Fitter. Speech, Language and Hearing Service Providers / Audiologist is her primary health care specialty. Blackington, Stacy L can be contacted via phone (417) 875-3600.

Contact Information

Primary practice address
960 E Walnut Lawn St Springfield MO 65807-7506
Phone: (417) 875-3600
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Speech, Language and Hearing Service Providers / Audiologist 231H00000X 2002019898 Missouri
Speech, Language and Hearing Service Providers / Audiologist-Hearing Aid Fitter 237600000X 2002019898 Missouri

Profile Details

NPI number 1710069745
LBN Legal business name Blackington, Stacy L
Credentials AU.D.
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 19th, 2006
Last updated Dec 30th, 2013 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1710069745 NPPES
Missouri MEDICAID 1710069745

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