Provider Demographics
NPI:1518358050
Name:SIKES, STACIA CASHION (MCD, SLP-CCC)
Entity type:Individual
Prefix:
First Name:STACIA
Middle Name:CASHION
Last Name:SIKES
Suffix:
Gender:F
Credentials:MCD, SLP-CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:408 TUPELO DR
Mailing Address - Street 2:
Mailing Address - City:LONGVIEW
Mailing Address - State:TX
Mailing Address - Zip Code:75601-5135
Mailing Address - Country:US
Mailing Address - Phone:903-241-1373
Mailing Address - Fax:
Practice Address - Street 1:408 TUPELO DR
Practice Address - Street 2:
Practice Address - City:LONGVIEW
Practice Address - State:TX
Practice Address - Zip Code:75601-5135
Practice Address - Country:US
Practice Address - Phone:903-241-1373
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-02-05
Last Update Date:2015-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX100083235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist