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Individual

MISS MARY ELLEN MITTENBURG

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.S., CF-SLP

Contact information

Practice address
717 E 16TH ST, SEDALIA, MO 65301-7623
(660) 826-9093
Mailing address
717 E 16TH ST, SEDALIA, MO 65301-7623
(660) 826-9093

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2011020930
MO

Other

Enumeration date
08/30/2011
Last updated
08/30/2011
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