Individual
ANDREA PEABODY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
14733 CLAYTON RD, MANCHESTER, MO 63011-2660
(314) 339-7732
Mailing address
5363 ODELL ST, SAINT LOUIS, MO 63139-1414
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
20220381558
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2022038158
—
MO
Enumeration date
12/12/2022
Last updated
12/12/2022
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