Individual
KELLY LYN HATINA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
12303 DEPAUL DR, BRIDGETON, MO 63044
(314) 447-5847
Mailing address
12303 DEPAUL DRIVE, BRIDGETON, MO 63044
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2025024445
MO
Other
Enumeration date
07/22/2025
Last updated
07/22/2025
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