Individual
KATHLEEN ANNE MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MACCCSLP
Contact information
Practice address
2652 S WALLIS SMITH BLVD, SPRINGFIELD, MO 65804-3864
(417) 429-0404
Mailing address
2652 S WALLIS SMITH BLVD, SPRINGFIELD, MO 65804-3864
(417) 429-0404
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
01510
MO
Other
Enumeration date
02/24/2007
Last updated
07/08/2007
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