Individual
KATHERINE BAKOURIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
12110 CLAYTON RD, SAINT LOUIS, MO 63131-2599
(314) 989-8100
Mailing address
2410 S 11TH ST APT B, SAINT LOUIS, MO 63104-4306
(815) 713-9844
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
146.014761
IL
235Z00000X
Speech-Language Pathologist
Primary
2018019773
MO
Other
Enumeration date
07/17/2019
Last updated
08/30/2021
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