Individual
MAKAYLA GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
1404 TRIAD CENTER DR, SAINT PETERS, MO 63376-7351
(314) 254-2188
Mailing address
1404 TRIAD CENTER DR, ST. CHARLES, MO 63376
(417) 631-3063
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2023032981
MO
Other
Enumeration date
04/10/2025
Last updated
04/10/2025
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