Individual
LAURA PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
330 N GORE AVE, SAINT LOUIS, MO 63119-1600
(314) 968-2060
Mailing address
9118 HERITAGE DR, APT B, SAINT LOUIS, MO 63123-4149
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2015018772
MO
Other
Enumeration date
07/06/2015
Last updated
07/06/2015
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