Individual
MRS. TARA GRETCHEN MOUSER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MCDCCCSLP
Contact information
Practice address
505 COURT ST., BLOOMFIELD, MO 63825
(573) 568-4562
(573) 568-4563
Mailing address
1321 BUISNESS HWY 60 W, DEXTER, MO 63841
(573) 624-3150
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
112138
MO
Other
Enumeration date
06/08/2007
Last updated
07/08/2007
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