Mrs Stacy M Depriest, CCC-SLP | |
302 N 4th Ave, Ozark, MO 65721-6656 | |
(417) 582-5900 | |
(417) 582-5960 |
Full Name | Mrs Stacy M Depriest |
---|---|
Gender | Female |
Speciality | Speech-language Pathologist |
Location | 302 N 4th Ave, Ozark, Missouri |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1194900480 | NPI | - | NPPES |
465127512 | Medicaid | MO |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
235Z00000X | Speech-language Pathologist | 118227 (Missouri) | Primary |
Provider Name | Aegis Group Practice Llc |
---|---|
Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1558819508 PECOS PAC ID: 5193036432 Enrollment ID: O20161109000544 |
Mailing Address | Practice Location Address |
---|---|
Mrs Stacy M Depriest, CCC-SLP 302 N 4th Ave, Po Box 166, Ozark, MO 65721-6656 Ph: (417) 582-5900 | Mrs Stacy M Depriest, CCC-SLP 302 N 4th Ave, Ozark, MO 65721-6656 Ph: (417) 582-5900 |
Mrs. Wendi Ann Hunt, M.S. CCC-SLP Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 4320 N 8th St, Ozark, MO 65721 Phone: 417-581-5860 | |
Carla Segress, Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 302 N 4th Ave, Ozark, MO 65721 Phone: 417-582-5952 Fax: 417-582-5960 | |
Kimberly Gaisford, Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 302 N 4th Ave, Ozark, MO 65721 Phone: 417-582-5900 | |
Rena Nims, Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 304 N 4th Avenue, Ozark, MO 65721 Phone: 417-582-5952 Fax: 417-582-5960 | |
Elizabeth Dawson, M.S., CCC-SLP Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 302 N 4th Ave, Ozark, MO 65721 Phone: 417-582-5900 | |
Mrs. Kara Nicole Peterson, M.S., CCC-SLP/L Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 302 N 4th Ave., Ozark, MO 65721 Phone: 417-582-5957 | |
Doreen Hasner, Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 302 N 4th Ave, Ozark, MO 65721 Phone: 417-582-5952 Fax: 417-582-5960 |