Lakeside Therapy Group
NPI #1033312574 in Bridgeport, West Virginia
Provider Information
- NPI Number
- 1033312574
- Entity Type
- Organization
- Organization Name
- Lakeside Therapy Group
- Primary Specialty
- Speech-Language Pathologist
- Enumeration Date
- Jun 11, 2007
- Last Updated
- Aug 22, 2020
Practice Location
- Address
- 765 BRIGHTRIDGE DRIVE
- City
- Bridgeport
- State
- West Virginia
- ZIP Code
- 26330
- Phone
- (304) 844-0099
Authorized Official
- Name
- MRS. STACY ELIZABETH BASTIN, MA CCC SLP
- Title
- MEMBER SPEECH THERAPIST
- Phone
- (304) 844-0099
Specialties & Taxonomy Codes
| Specialty |
|---|
| Speech-Language Pathologist |
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