Individual
MRS. REGINA MARIE NOLAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S. CCC-SLP
Contact information
Practice address
1208 FOXVIEW TER, BALLWIN, MO 63011-4316
(314) 719-7140
Mailing address
1208 FOXVIEW TER, BALLWIN, MO 63011-4316
(314) 719-7140
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
109811
MO
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
109811
MO
Other
Enumeration date
04/10/2007
Last updated
06/04/2015
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