Individual
JANE BRENGARTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
736 MAIN ST, BOONVILLE, MO 65233-1656
(660) 882-7474
Mailing address
736 MAIN ST, BOONVILLE, MO 65233-1656
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
255177
MO
Other
Enumeration date
08/09/2017
Last updated
08/09/2017
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