Individual
NICOLE LEIGH HARTRUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
110 VIRGIL ST, SPECIAL SERVICES, O FALLON, MO 63366-2637
(636) 240-2072
(636) 240-2072
Mailing address
555 EAST TERRA LANE, SPECIAL SERVICES, O FALLON, MO 63366-2637
(636) 240-2072
(636) 240-2072
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2013025905
MO
Other
Enumeration date
08/08/2013
Last updated
09/09/2015
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