Individual
KELLY HERBST
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S. CCC-SLP
Contact information
Practice address
15955 NEW HALLS FERRY RD, FLORISSANT, MO 63031-1227
(314) 953-4995
Mailing address
11325 MOMARTE LN, SAINT LOUIS, MO 63146-5335
(314) 580-0578
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2010028183
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1285940601
—
MO
Enumeration date
08/23/2010
Last updated
11/25/2013
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