Individual
LAURA M GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MED CCC-SLP
Contact information
Practice address
1401 W AUSTIN ST, WEBB CITY, MO 64870-1617
(417) 850-4316
Mailing address
1829 PHILADELPHIA, WEBB CITY, MO 64870-1093
(417) 850-4316
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
106954
MO
Other
Enumeration date
02/22/2007
Last updated
07/09/2007
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