Individual
KELLY ROY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
12300 S 40 DR, SAINT LOUIS, MO 63141-8820
(314) 692-7172
Mailing address
12300 S 40 DR, SAINT LOUIS, MO 63141-8820
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2017022373
MO
Other
Enumeration date
03/02/2018
Last updated
03/02/2018
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