Individual
LISA MARIE GRODEON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
20 GRAY AVE, SAINT LOUIS, MO 63119-2912
(618) 581-3025
Mailing address
9329 QUEENSTON DR, SAINT LOUIS, MO 63126-2723
(618) 581-3025
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
41149
MO
235Z00000X
Speech-Language Pathologist
—
—
Other
Enumeration date
03/08/2018
Last updated
03/08/2018
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