Individual
MEDEA MARIE BOGUSLAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
1202 W 3RD ST, CAMERON, MO 64429-1402
(816) 632-5859
Mailing address
1202 W 3RD ST, CAMERON, MO 64429-1402
(816) 632-5859
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2004012746
MO
Other
Enumeration date
12/02/2005
Last updated
07/08/2007
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