Individual
MS. CARLY ROSE NOVELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
1044 N MASON RD, DEPT OTOLARYNGOLOGY, STE L20, CREVE COEUR, MO 63141-6431
(314) 362-7509
(314) 362-7522
Mailing address
PO BOX 7412011, CHICAGO, IL 60674-2011
(314) 362-7509
(314) 362-7522
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2022024563
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
460149335
—
MO
Enumeration date
08/15/2022
Last updated
04/17/2025
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