Individual
MS. JORDAN NICOLE KLINCKHARDT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2621 HIGHWAY K, O FALLON, MO 63368-7865
(636) 978-4001
Mailing address
2621 HIGHWAY K, O FALLON, MO 63368-7865
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2015033486
MO
Other
Enumeration date
09/22/2015
Last updated
09/22/2015
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