Individual
JESSICA MARIE CHITWOOD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2 GATEWAY DR, SAINT LOUIS, MO 63106-2715
(314) 241-0993
Mailing address
80 LIEDERKRANZ LN, MILLSTADT, IL 62260-2259
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2017028647
MO
Other
Enumeration date
08/10/2017
Last updated
08/10/2017
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