Pardue, Stacie L

Pardue, Stacie L is an individual health care provider with primary practice located at 4440B 26Th St W , Bradenton FL 34207-1201. 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. Pardue, Stacie L can be contacted via phone (941) 752-0408.

Contact Information

Primary practice address
4440B 26Th St W Bradenton FL 34207-1201
Fax: (941) 870-0876
Website:

Health care specialties

SpecialtyCodeLicense #State
Speech, Language and Hearing Service Providers / Speech-Language Pathologist 235Z00000X SLP007210 Georgia

Profile Details

NPI number 1578609111
LBN Legal business name Pardue, Stacie L
Credentials Master of Arts (MA)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 30th, 2007
Last updated Oct 29th, 2012 - about 14 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 1578609111 NPPES
Florida MEDICAID 890256900

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