Individual
MAGGIE BANAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
555 E TERRA LN, O FALLON, MO 63366-2725
(636) 240-2072
(636) 980-1946
Mailing address
498 PARKGATE DR, O FALLON, MO 63367-4379
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2015024042
MO
Other
Enumeration date
07/29/2015
Last updated
08/15/2017
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