Individual
MIA ELMORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4554 LACLEDE AVE APT 308, SAINT LOUIS, MO 63108-2147
(217) 553-8539
Mailing address
4554 LACLEDE AVE APT 308, SAINT LOUIS, MO 63108-2147
(217) 553-8539
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2016022338
MO
Other
Enumeration date
09/14/2020
Last updated
09/14/2020
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