Individual
MARK BROWN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
14733 CLAYTON RD, BALLWIN, MO 63011-2660
(773) 701-2245
Mailing address
908 EASTGATE AVE APT 2N, SAINT LOUIS, MO 63130-3340
(773) 701-2245
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2017016565
MO
Other
Enumeration date
05/03/2018
Last updated
05/03/2018
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