Individual
JENNIFER CARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.A.
Contact information
Practice address
1408 WATERFORD DR, COLUMBIA, MO 65203-0440
(573) 446-0523
Mailing address
284 MERCHANT ST, SAINTE GENEVIEVE, MO 63670-1610
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
111757
MO
Other
Enumeration date
03/12/2007
Last updated
07/08/2007
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