Provider Demographics
NPI:1154044550
Name:AILES, STACEY
Entity type:Individual
Prefix:
First Name:STACEY
Middle Name:
Last Name:AILES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 BALTIC CT
Mailing Address - Street 2:
Mailing Address - City:CHAPIN
Mailing Address - State:SC
Mailing Address - Zip Code:29036-7325
Mailing Address - Country:US
Mailing Address - Phone:803-260-8489
Mailing Address - Fax:877-247-3488
Practice Address - Street 1:120 BALTIC CT
Practice Address - Street 2:
Practice Address - City:CHAPIN
Practice Address - State:SC
Practice Address - Zip Code:29036-7325
Practice Address - Country:US
Practice Address - Phone:803-260-8489
Practice Address - Fax:864-572-4080
Is Sole Proprietor?:No
Enumeration Date:2022-09-21
Last Update Date:2025-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist