Provider Demographics
NPI:1033729769
Name:CASIMIR, STASHIA MARIE (SLP)
Entity Type:Individual
Prefix:
First Name:STASHIA
Middle Name:MARIE
Last Name:CASIMIR
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:225 N ELDER AVE
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65802-5457
Mailing Address - Country:US
Mailing Address - Phone:712-899-4709
Mailing Address - Fax:
Practice Address - Street 1:234 E ANDERSON ST
Practice Address - Street 2:
Practice Address - City:REPUBLIC
Practice Address - State:MO
Practice Address - Zip Code:65738-1300
Practice Address - Country:US
Practice Address - Phone:417-723-3620
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-06
Last Update Date:2020-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2020025130235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist