Individual
MS. LAURA ELLEN GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
12430 TESSON FERRY RD, STE 352, SAINT LOUIS, MO 63128-2702
(866) 495-5437
Mailing address
3047 DELAVAN DR, SAINT LOUIS, MO 63121-4611
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
1999137385
MO
Other
Enumeration date
02/20/2007
Last updated
07/08/2007
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