Mathis, Stacey Leigh

Mathis, Stacey Leigh is an individual health care provider with primary practice located at 5600 Goodman Rd Ste D , Olive Branch MS 38654-7002. She recently has only one registered license in Speech, Language and Hearing Service Providers / Speech-Language Pathologist, which is considered as her primary health care specialty. Mathis, Stacey Leigh can be contacted via phone (662) 895-4545.

Contact Information

Primary practice address
5600 Goodman Rd Ste D Olive Branch MS 38654-7002
Fax: (662) 895-4546
Website:

Health care specialties

SpecialtyCodeLicense #State
Speech, Language and Hearing Service Providers / Speech-Language Pathologist 235Z00000X S2304 Mississippi

Profile Details

NPI number 1023039906
LBN Legal business name Mathis, Stacey Leigh
Credentials MS,CCC-SLP
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 23rd, 2006
Last updated Jul 8th, 2007 - about 19 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 1023039906 NPPES
Mississippi MEDICAID 09877809

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