Individual
MADALYN MICHAEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2824 SECKMAN RD, IMPERIAL, MO 63052-1941
(636) 296-2030
Mailing address
3629 MORGAN WAY, IMPERIAL, MO 63052-4106
(314) 520-3127
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2023033488
MO
Other
Enumeration date
08/23/2023
Last updated
08/23/2023
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