LAKESIDE THERAPY GROUP
Speech Language Pathology at Brightridge Dr, Lake Ridge, WV

License number
West Virginia SLP 0710
Category
Speech Language Pathology
Type
Speech-Language Pathologist
Owner
Name: MRS. STACY ELIZABETH BASTIN MA CCC SLP
Title: MEMBER SPEECH THERAPIST
Phone: (304) 844-0099
Address
Address
765 Brightridge Dr, Lake Ridge, WV 26330
National Provider ID: 1033312574
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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LAKESIDE THERAPY GROUP LLC

Lake Ridge, WV

Industry:
Specialty Outpatient Clinic
Doing business as:
Lakeside Therapy Group
Registration:
Apr 7, 2004
Addresses:
PO Box 327, Bridgeport, WV 26330 (Mailing)
765 Brightridge Dr, Lake Ridge, WV 26330
Business type:
Limited Liability Company
Organizers:
Paul Bastin (Member), PO Box 327, Bridgeport, WV 26330,Stacy Bastin (Member, Principal, Speech Therapist), PO Box 327, Bridgeport, WV 26330,Paul Bastin Iii (Organizer), 125 Maple Lk, Bridgeport, WV 26330

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