| Stacey Wallen, PH D, CCC-SLP | |
|
3201 Rockport Dr, Lithonia, GA 30038-1834 | |
| (954) 415-4069 | |
| Not Available |
| Full Name | Stacey Wallen |
|---|---|
| Gender | Female |
| Speciality | Speech-language Pathologist |
| Location | 3201 Rockport Dr, Lithonia, Georgia |
| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376657114 | NPI | - | NPPES |
| SLP006932 | Other | GA | GA LICENSE NUMBER |
| SA5662 | Other | FL | STATE LICENSE NUMBER |
| 003121866B | Medicaid | GA | |
| 8857075 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 235Z00000X | Speech-language Pathologist | SA5662 (Florida) | Secondary |
| 235Z00000X | Speech-language Pathologist | SLP006932 (Georgia) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Stacey Wallen, PH D, CCC-SLP 2209 Discovery Cir W, Deerfield Beach, FL 33442-1006 Ph: (954) 415-4069 | Stacey Wallen, PH D, CCC-SLP 3201 Rockport Dr, Lithonia, GA 30038-1834 Ph: (954) 415-4069 |
Miss Tameka Blanette Bacon, Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 7327 Vigo Dr, Lithonia, GA 30058 Phone: 404-808-2323 | |
Amye Slate, Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 7162 Lone Oak Way, Lithonia, GA 30058 Phone: 404-606-3755 Fax: 877-730-2912 | |
Ms. Treva Tai Bibbs-bugg, M.ED-SLP Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 3123 Klondike Rd, Lithonia, GA 30038 Phone: 770-482-3828 | |
Kaitlin Commiskey, M.A. CCC/SLP Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 7162 Lone Oak Way, Lithonia, GA 30058 Phone: 404-606-3755 Fax: 770-696-1065 | |
Raven Samone Watkins, Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 2537 Oakleaf Rdg, Lithonia, GA 30058 Phone: 205-499-5837 | |
Annissia C. Davis, SLP Speech-Language Pathologist Medicare: Medicare Enrolled Practice Location: 7162 Lone Oak Way, Lithonia, GA 30058 Phone: 404-248-0415 Fax: 404-248-0422 | |
Ms. Felicia Janel Alford, M.A.CCC-SLP Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 1562 Rice Sq, Lithonia, GA 30058 Phone: 678-526-2760 |