Individual
MISS DEBORAH FAYE GARDNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
801 N 11TH ST, SAINT LOUIS, MO 63101-1015
(314) 231-3720
Mailing address
801 N 11TH ST, SAINT LOUIS, MO 63101-1015
(314) 231-3720
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
137953
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
137953
—
MO
Enumeration date
10/31/2012
Last updated
11/07/2012
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