Individual
MRS. BRANDI MICHELLE WALLGREN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.A, CF-SLP
Contact information
Practice address
100 S GARRISON AVE, SAINT LOUIS, MO 63103-2538
(314) 340-5902
Mailing address
1105 BELLA VISTA DR, JACKSON, MO 63755-7850
(573) 803-7434
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2016026106
MO
Other
Enumeration date
08/29/2016
Last updated
08/29/2016
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