Individual
REBECCA STOUTENBOROUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CCC/SLP
Contact information
Practice address
6005 CEDAR HIILL RD., CEDAR HIILL, MO 63016-2115
(636) 274-0555
Mailing address
6005 CEDAR HILL RD, CEDAR HILL, MO 63016-2115
(636) 274-0500
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2000155779
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2000155779
LICENSE NUMBER
MO
Enumeration date
10/31/2008
Last updated
10/31/2008
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